Predicting ICU length of stay using APACHE-IV in persons with severe sepsis – a pilot study

Abstract

Introduction: Accurate length of stay (LOS) prediction of severe sepsis patients in intensive care unit (ICU) is critical for resource management. Acute Physiology and Chronic Health Evaluation-IV (APACHE-IV) model is commonly used forpredicting LOS. This study assesses the ICU-LOS predictability of APACHE-IV system for severe sepsis patients.Methods: Following ethical clearance, we used ICU data (06/2006 – 08/2008: from a hospital in India) to compare APACHE-IV score and predicted LOS of severe sepsis patients with actual observed ICU-LOS. We employed t-test, correlations, ANOVA andlinear regression of suitably transformed variables as needed.Results: Out of 3,949 ICU admissions, 198 were severe sepsis admissions where 134 patients (80%) had usable data. Of these 75 had verifiable APACHE-IV scores (final sample) with 55% men; median age: 67 years (IQR: 21) 53% did not have dialysis; 87% were on mechanical ventilation (MV). Mean ICU-LOS (10.1 days + 6.4) was significantly greater than predicted ICU-LOS (5.6days + 1.8 ; p