Effects of APACHE II Score and Initial Nutritional Status on Prognosis of the Critically Ill Patients
안서희; 라세희; 신증수; 이덕철; 임현선; 장철호
대한중환자의학회지, Vol.27(2) : 102~107, 2012
Background: Malnutrition is common in hospitalized patients, especially in critically ill patients and affects their
mortality and morbidity. However, the correlation between malnutrition and poor outcome is not fully understood.
Our hypothesis is that the nutritional effect on the patient’s prognosis would differ depending on the severity of the
Methods: 3,758 patients admitted to the intensive care unit (ICU) were observed retrospectively. Patients were
divided into well, moderate and severe groups, according to their nutritional status as assessed by their serum albumin
level and total lymphocyte count (TLC). The severity of the disease was assessed by the Acute Physiologic
and Chronic Health Evaluation (APACHE II score). All patients were followed clinically until discharge or death
and ICU days, hospital days, ventilator days, and mortality rates were recorded.
Results: Depending on the definition used, the prevalence of hospital malnutrition is reported to be 68.3%.
Hospital days, ICU days, as well as ventilator days of moderate and severe groups were longer than the well group.
In patients exhibiting mild severity of disease, moderate and severe malnutrition groups have 3－5 times the mortality
rate than the well group.
Conclusions: Malnutrition affects the prognosis of patients who have an APACHE II score ranging from 4－29
points. Active nutritional support may be more effective for patients with a disease of mild severity.