1. Volume 64, Issue 6, Pages 441-449 (December 2014)
New scoring system (APACHE-HF) for predicting adverse outcomes in patients with acute heart failure: Evaluation of the APACHE II and Modified APACHE II scoring systems 
Hirotake Okazaki, MD, Akihiro Shirakabe, MD, PhD, Noritake Hata, MD, PhD, Masanori Yamamoto, MD, PhD, Nobuaki Kobayashi, MD, PhD, Takuro Shinada, MD, PhD, Kazunori Tomita, MD, Masafumi Tsurumi, MD, Masato Matsushita, MD, Yoshiya Yamamoto, MD, Shinya Yokoyama, MD, PhD, Kuniya Asai, MD, PhD, Wataru Shimizu, MD, PhD, FJCC 
Journal of Cardiology 
Volume 64, Issue 6, Pages (December 2014)
DOI: /j.jjcc
Copyright © 2014 Japanese College of Cardiology Terms and Conditions

2. Fig. 1
Definition of each scoring system. (A) The APACHE II scoring system was defined in this study. (B) The Modified APACHE II scoring system was constructed based on the significant APACHE II factors in the alive group [mean blood pressure (BP), sodium, potassium, creatinine, age, and Glasgow Coma Scale (GCS)] and was given points based on the APACHE II system. (C) The APACHE-HF scoring system was constructed based on the significant APACHE II factors in the alive group (mean BP, pulse, sodium, potassium, creatinine, hematocrit, age, and GCS) and was given one point for each cut-off value. The cut-off value for each factor was defined by the receiver-operating characteristic (ROC) curve as follows: mean BP [91.5mmHg, area under the ROC curve (AUC)=0.678, p<0.001), pulse (110.5beats/min, AUC=0.594, p=0.008), sodium (137.5mmol/L, AUC=0.613, p=0.001), potassium (4.85mmol/L, AUC=0.601, p=0.004), hematocrit (36.95mg/dL, AUC=0.617, p=0.001), creatinine (1.475mg/dL, AUC=0.676, p<0.001), age (71.5 years, AUC=0.572, p=0.042) and GCS (13.5, AUC=0.567, p=0.058)].
Journal of Cardiology  , DOI: ( /j.jjcc )
Copyright © 2014 Japanese College of Cardiology Terms and Conditions

3. Fig. 2
ROC curves for each scoring system. The APACHE II system demonstrated an optimal balance between sensitivity and specificity (47.3% and 67.3%; AUC=0.588, p=0.012) at 17.5 points (black line), while the Modified APACHE II system demonstrated an optimal balance between sensitivity and specificity (51.4% and 69.4%, AUC 0.590, p=0.001) at 9.5 points (blue line) and the APACHE-HF system demonstrated an optimal balance between sensitivity and specificity (87.8% and 63.9%, AUC 0.779, p<0.001) at 2.5 points (red line). ROC, receiver-operating characteristic; AUC, area under the ROC curve; HF, heart failure.
Journal of Cardiology  , DOI: ( /j.jjcc )
Copyright © 2014 Japanese College of Cardiology Terms and Conditions

4. Fig. 3
Kaplan–Meier curves for each scoring system. (A) The prognosis, including all-cause death, did not differ between the patients with an APACHE II score of ≤17 and those with an APACHE II score of ≥18. (B) The prognosis, including HF events, was significantly poorer in the patients with an APACHE II score of ≥18 than in those with an APACHE II score of ≤17. (C) The prognosis, including all-cause death, was significantly poorer in the patients with a Modified APACHE II score of ≥10 than in those with a Modified APACHE II score of ≤9. (D) The prognosis, including HF events, was significantly poorer in the patients with a Modified APACHE II score of ≥10 than in those with a Modified APACHE II score of ≤9. (E) The prognosis, including all-cause death, was significantly poorer in the patients with an APACHE-HF score of ≥3 than in those with an APACHE II-HF score of ≤2. (F) The prognosis, including HF events, was significantly poorer in the patients with an APACHE-HF score of ≥3 than in those with an APACHE II-HF score of ≤2. HF, heart failure.
Journal of Cardiology  , DOI: ( /j.jjcc )
Copyright © 2014 Japanese College of Cardiology Terms and Conditions

5. Fig. 4
Kaplan–Meier curves for the APACHE-HF scoring system. (A) The Kaplan–Meier curves revealed a poorer prognosis, including all-cause death, in Group 5 and Group 4 than in the other groups, in Group 3 than in Group 2 or Group 1, and in Group 2 than in Group 1. (B) The Kaplan–Meier curves revealed a poorer prognosis, including HF events, in Group 5 and Group 4 than in the other groups, in Group 3 than in Group 2 or Group 1, and in Group 2 than in Group 1. HF, heart failure.
Journal of Cardiology  , DOI: ( /j.jjcc )
Copyright © 2014 Japanese College of Cardiology Terms and Conditions