<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3>
<p>Intermediate care units (IMCUs) serve as step-up units for emergency department patients and as step-down units for critically ill patients transferred from intensive care units. This study compares four critical illness scores for assessment of acutely ill patients and their accuracy in predicting mortality in patients admitted to IMCU.</p>
</sec>
<sec><h3>Methods</h3>
<p>A comparative cross-sectional study on patients aged ≥18 admitted to IMCU of Aga Khan University Hospital from 2017 to 2019. All patients admitted to IMCU from the emergency room were included in the study. Patient’s record were reviewed for demographic data, physiological and laboratory parameters. Critical illness scores were calculated from these variables for each patient.</p>
</sec>
<sec><h3>Results</h3>
<p>A total of 1192 patients were admitted to the IMCU, of which 923 (77.4%) medical records were finally analyzed. The mean (SD) age of participants was 62 years (± 16.5) and 469 (50.8%) were women. The overall hospital mortality rate of patients managed in IMCU was 6.4% (59/923 patients). The median scores of APACHE II, SOFA, SAPS II and MEWS were 16 (IQR 11–21), 4 (IQR 2–6), 36 (IQR 30–53) and 3 (IQR 2–4) points respectively. AUC for SAPS II was 0.763 (95% CI: 0.71–0.81), SOFA score was 0.735 (95% CI: 0.68–0.79) and MEWS score was 0.714 (95% CI: 0.66–0.77). The lowest ROC curve was 0.584 (95% CI: 0.52–0.64) for APACHE II.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>In conclusion, our study found that SAPS II, followed by SOFA and MEWS scores, provided better discrimination in stratifying critical illness in patients admitted to IMCU of a tertiary care hospital in Pakistan.</p>
</sec>
</abstract>

Introduction
Intermediate care units (IMCUs) serve as step-up units for emergency department patients and as step-down units for critically ill patients transferred from intensive care units. This study compares four critical illness scores for assessment of acutely ill patients and their accuracy in predicting mortality in patients admitted to IMCU.

Methods
A comparative cross-sectional study on patients aged ≥18 admitted to IMCU of Aga Khan University Hospital from 2017 to 2019. All patients admitted to IMCU from the emergency room were included in the study. Patient’s record were reviewed for demographic data, physiological and laboratory parameters. Critical illness scores were calculated from these variables for each patient.

Results
A total of 1192 patients were admitted to the IMCU, of which 923 (77.4%) medical records were finally analyzed. The mean (SD) age of participants was 62 years (± 16.5) and 469 (50.8%) were women. The overall hospital mortality rate of patients managed in IMCU was 6.4% (59/923 patients). The median scores of APACHE II, SOFA, SAPS II and MEWS were 16 (IQR 11–21), 4 (IQR 2–6), 36 (IQR 30–53) and 3 (IQR 2–4) points respectively. AUC for SAPS II was 0.763 (95% CI: 0.71–0.81), SOFA score was 0.735 (95% CI: 0.68–0.79) and MEWS score was 0.714 (95% CI: 0.66–0.77). The lowest ROC curve was 0.584 (95% CI: 0.52–0.64) for APACHE II.

Conclusion
In conclusion, our study found that SAPS II, followed by SOFA and MEWS scores, provided better discrimination in stratifying critical illness in patients admitted to IMCU of a tertiary care hospital in Pakistan.

Comparison of Critical Illness Score in Patients Admitted to Intermediate Care Units of a Tertiary Care Hospital: A Comparative Cross-Sectional Study from Karachi, Pakistan

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction
Intermediate care units (IMCUs) serve as step-up units for emergency department patients and as step-down units for critically ill patients...

Comparison of Critical Illness Score in Patients Admitted to Intermediate Care Units of a Tertiary Care Hospital: A Comparative Cross-Sectional Study from Karachi, Pakistan

Article Category: Research Article

Published Online: Jan 30, 2024

Page range: 38 - 48

Received: Aug 09, 2023

Accepted: Nov 13, 2023

DOI: https://doi.org/10.2478/jccm-2024-0003

Keywords
APACHE, critical illness, early warning score, simplified acute physiology score, SOFAS

© 2024 Amber Sabeen Ahmed et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Comparison of Critical Illness Score in Patients Admitted to Intermediate Care Units of a Tertiary Care Hospital: A Comparative Cross-Sectional Study from Karachi, Pakistan

Article Category: Research Article

Published Online: Jan 30, 2024

Page range: 38 - 48

Received: Aug 09, 2023

Accepted: Nov 13, 2023

DOI: https://doi.org/10.2478/jccm-2024-0003

KeywordsAPACHE, critical illness, early warning score, simplified acute physiology score, SOFAS

© 2024 Amber Sabeen Ahmed et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
APACHE, critical illness, early warning score, simplified acute physiology score, SOFAS