Value of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting the hospital mortality for postoperative brain tumor patients admitted to the intensive care units in Japan: A Retrospective Case-Control Study.

Abstract

Abstract Objective No prognostic predictors for brain tumors based on ICU admission data have been reported. APACHE II is a score based on the data of patients admitted to the ICU and is often correlated with the severity of the disease and prognosis. However, no studies have reported an association between APACHE Ⅱand the prognosis of brain tumor patients. Since 2014, the Japanese Intensive care Patients Database (JIPAD) was established by the Japanese Society of Intensive Care Medicine (JSICM) to construct a high-quality ICU database as a national registry with the goal of improving the quality of care and pursuing the development of intensive care medicine in Japan. We used JIPAD to examine the factors associated with in-hospital mortality based on the background of postoperative patients with brain tumors admitted to the ICU and the data from the ICU. Methods Patients aged ≥16 years enrolled in JIPAD between April 2015 and March 2018 after surgery for brain tumors underwent craniotomy or biopsy. We examined factors related to outcomes at discharge from data such as blood tests and medical procedures during ICU admission, tumor type, and APACHE II score. Results Of the 1,454 cases (male:female ratio: 1:1.1, mean age: 62 years) included in the study, 32 cases (2.2%) died in hospital. In multivariate analysis, male (OR 2.70 [95%CI 1.21–6.03]), malignant tumor (OR 2.94 [95%CI 1.31–6.59]), ventilator use (OR 2.67 [95%CI 1.19–5.98]), APACH II score ≥ 15 (OR 5.46 [95%CI 2.49–11.9]) were significantly associated with in-hospital mortality. Conclusion Factors related to in-hospital mortality in postoperative brain tumor patients cannot be improved in advance, but by picking up cases with a high risk of in-hospital death at an early stage, it is possible to devise methods of treatment and support for the patient's family.