ReviewWorld journal of emergency medicine2026
Comparison of predictive values of Acute Physiology and Chronic Health Evaluation scores for mortality in sepsis: a systematic review and meta-analysis.
Review in World journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
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Abstract
backgroundAcute Physiology and Chronic Health Evaluation (APACHE) scores are widely used in emergency medicine and critical care settings, yet their prognostic accuracy for sepsis-related mortality across different versions remains to be assessed thoroughly. This study aimed to compare the pooled prognostic performance of APACHE II, III, and IV in predicting in-hospital mortality in patients with sepsis.
methodsWe conducted a systematic review and meta-analysis by searching for articles in the PubMed, Embase, Web of Science, and Cochrane databases, with a publication date range from February 23, 2016, to June 8, 2024. Random effects models were employed to analyse pooled data, focusing on key metrics such as the area under the curve (AUC), diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR).
resultsA total of 33 articles were analyzed, 3 of which examined multiple APACHE scores. These articles collectively involved 60,041 patients: 25 articles with 9,619 patients assessed APACHE II, 4 articles with 32,862 patients assessed APACHE III, and 8 articles with 21,741 patients assessed APACHE IV. The AUC for in-hospital mortality improved progressively across versions: 0.75 (95%
conclusionAPACHE IV demonstrated the superior prognostic accuracy to the other versions for sepsis-related mortality. With the increasing adoption of automated calculations through standardized software, APACHE IV might be incorporated into routine clinical workflows.
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