Effectiveness of APACHE II and SAPS II scoring models in foreseeing the outcome of critically ill COPD patients Yousef Ahmed, Mohamed Adam, Lamees M. Bakkar Background Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems are the two models that are greatly used by the majority of ICUs to predict clinical consequence. Objective The aim of the study was to assess the performance of APACHE II and SAPS II scoring methods in foreseeing death among critically ill chronic obstructive pulmonary disease (COPD) patients. Materials and methods This prospective research included 104 COPD patients who were admitted to the respiratory intensive care unit (RICU) at Assiut University Hospital. The patients were classified as survivors and nonsurvivors. Each scoring system was assessed for its discrimination, calibration, and overall performance. Results On the basis of the outcome of the study population, 36 (34.6%) patients were non-survivors while 68 (65.4%) patients were survivors. Both APACHE II and SAPS II scores were significantly higher in nonsurvivors. The discriminative power of both models was good as determined by the receiver operating characteristic curve. At a cutoff point greater than 20 for APACHE II and greater than 48 for SAPS II, survival or death can be predicted. The Lemeshow–Hosmer goodness- of-fit C statistics showed good performance and good calibration for both models. APACHE II score had the least Brier score and reliability but had the highest resolution. Conclusion The conclusions made were first, APACHE II and SAPS II have nearly similar performance in predicting mortality among COPD patients but with some preference for APACHE. Second, Both models have good discrimination and good calibration. Egypt J Bronchol 2019 13:654–659 © 2020 Egyptian Journal of Bronchology Egyptian Journal of Bronchology 2019 13:654–659 Keywords: Acute Physiology and Chronic Health Evaluation II, Assiut, chronic obstructive pulmonary disease, respiratory intensive care unit, Simplified Acute Physiology Score II Chest Department, Faculty of Medicine, Assiut University, Assiut, Egypt Correspondence to Yousef Ahmed, MD, Chest Department, Faculty of Medicine, Assiut University Hospital, Assiut, 71515, Egypt. Tel: +20 102 503 3083; fax +20882333327; e-mail: yousef_ahmed1972@yahoo.com Received: 23 August 2019 Accepted: 24 November 2019 Published: Introduction Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating airway disease that results in a large burden, both medically and financially. It affects millions of people around the world and causes great rates of morbidity and mortality. This burden is anticipated to increase with an estimated 5.8 million deaths annually by 2030 [1]. A large proportion of patients with COPD usually require admission to the ICU and it may be helpful to recognize patients at the time of admission who are probable to have bad consequence, so that these patients can be managed violently [2]. There are many ICU scoring models, and numerous new systems are being progressed to assess severity of illness in ICU patients. The use of scoring models particularly developed for patient evaluation at the time of ICU entry has decreased many troubles and helped therapy delineation. Furthermore, these methods aid in assessing and comparing the goodness and magnitude of care between different health-care academies [3,4]. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems are the two models that are greatly used by the majority of ICUs to forecast the clinical consequence [5]. The aim of our study was to assess the performance of APACHE II and SAPS II scoring methods in forecasting death among critically ill COPD patients admitted to the respiratory intensive care unit (RICU) at Assiut University Hospital. Materials and methods This prospective, descriptive, comparative research was performed from January 2018 to March 2019 and included 104 COPD patients who were admitted to the RICU with severe exacerbation requiring admission to the RICU (severe dyspnea that responds inadequately to initial emergency therapy, changes in mental status, persistent or worsening hypoxemia, persistent or worsening respiratory acidosis, the need for invasive mechanical ventilation, and/or hemodynamic instability). The diagnosis of COPD was based on the patient’s medical history obtained from the patient himself and/or the family of the patient, consistent physical findings, previous spirometry and/or evidence of hyperinflation on current or previous chest radiograph. Excluded from this study were COPD This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Original article 654 © 2020 Egyptian Journal of Bronchology | Published by Wolters Kluwer - Medknow DOI: 10.4103/ejb.ejb_72_19 21 January 2020