Comparison of the New Score (APACHE-INf), Including Inflammatory and Nutritional Parameters, With APACHE-II in the Prognosis of Patients Admitted to ICU

Intensive care units are units where patients with high morbidity and mortality risk are followed up and treated. Risk stratification of patients in intensive care admission is very important in terms of quickly identifying patients who will require urgent diagnosis and treatment. For this reason, many scoring systems have been developed in recent years, and although the most common APACHE-II score is routinely applied in our intensive care units, there is no universally accepted consensus yet. Existing scoring systems predict prognosis mostly by evaluating organ dysfunction. The importance of inflammation and inflammatory response in organ functions has been better understood, especially in the COVID process. Nutritional status upon admission has not been evaluated in the current scoring systems.

Inflammation plays an important role in both regeneration and the fight against microorganisms at the cellular and tissue level. Recent studies have clearly demonstrated the importance of inflammation and inflammatory response in the morbidity and mortality of patients. In this context, there are studies reporting that some prominent inflammatory parameters are associated with morbidity and mortality rates in intensive care patients.

Based on the available evidence, it is evaluated that a scoring system that does not include inflammatory parameters cannot provide an accurate prognosis prediction.

the evaluation of nutritional status upon ICU admission is a vital component of patient care that has been largely overlooked in current scoring systems.

Malnourished patients are at a higher risk of developing complications, prolonged hospital stays, and increased mortality rates compared to well-nourished patients. Adequate nutrition not only supports immune function and tissue repair but also impacts the patient's response to therapeutic interventions and the prevention of complications during their ICU stay. Recognizing the significance of adequate nutrition in critical illness is essential to optimize patient outcomes and minimize complications. By integrating nutritional assessment into existing scoring systems, healthcare providers can identify malnourished patients early, implement timely interventions, and improve the overall quality of care in the ICU. This comprehensive approach holds promise for enhancing patient outcomes, reducing morbidity and mortality rates, and optimizing resource utilization in critical care settings.