Comparison of APACHE-II, SAPS and SOFA as the best predictor of mor-tality among critically ill patients.

Abstract

Objective: To find out the predictive ability of various scoring system including APACHE II, SOFA and SAPS II in finding the prognosis of critically ill patients.
Methodology: This cross-sectional study was conducted at Medical and Surgical intensive care units (ICU) and High dependency units, Dow University of Health Sciences Karachi Pakistan, from January 2025 to June 2025.. A total of 198 patients, aged 18-80 years, were recruited from the high dependency units, medical and surgical intensive care units. These patients diagnosed with sepsis after presenting with a serious condition. Vital signs, the GCS score, and a sys-tematic examination were used to evaluate the patients. Within 24 hours after admission, APACHE II, SAPS II, and SO-FA scores were assessed. Patients’ outcome at discharge was recorded and compared with predicted mortality by these scoring systems.
Results: Out of 198 patients, 89 (44.9%) did not survive. The mean APACHE-II score (19.13±3.65 vs. 26.33±2.74), SAP-II score (34.45±8.39 vs. 47.21±0.92) and SOFA score (7.27±2.07 vs. 11.00±1.26) were markedly elevated among non-survivors than survivors. SAPS II score showed the highest discriminatory power on ROC analysis (AUROC=0.979) fol-lowed by APACHE II score (AUROC=0.941) and SOFA score (AUROC=0.904).
Conclusion: The three prognostic scores (APACHE II, SAPS II, and SOFA) showed adequate accuracy in predicting mortality among critically ill patients with sepsis. Among them, SAPS II showed superior calibration and discriminatory power compared with APACHE II and SOFA.

Keywords: Critical illness, intensive care units, sepsis, mortality. APACHE II, SOFA, SAPS II