The evaluation of four scoring systems for critical care during acute blood purification therapy

Abstract

During acute blood purification, it is very important to estimate the severity and prognosis precisely in order to select the appropriate treatment and manage medical resources efficiently. Such a precise estimate can be also useful for explaining the situation to a patient and family during the informed. Twenty-eight patients who needed acute dialysis in our hospital between December 2005 and May 2006 were divided into two groups. The first group of 14 patients died after treatment and the second group of 14 patients survived. The prognosis was assessed by 4 scales : APACHEII, SOFA, MODS, and the Japanese organ severity score, and the appropriateness of the treatment and uses of medical resources were also evaluated. APACHEII score did not show any significant difference between the two groups. However, when scores were under 9 points by SOFA, under 5 by MODS, and under 6 by Japanese organ severity score, the patient survival rate was 100%. Especially, the Japanese organ severity score was the most reliable of the four scales in estimating the prognosis precisely. Blood purification treatment is an effective treatment, but its medical cost is extremely high. Therefore, we have to select the treatment and patient appropriately.