1Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Indonesia
2Dr. Ramelan Navy Central Hospital, Surabaya, Indonesia
3Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Indonesia
*Corresponding Author
Acute Respiratory Distress Syndrome (ARDS) represents a critical illness with a strong association to high mortality in the intensive care unit. As a marker of both nutritional and inflammatory status, the Prognostic Nutritional Index (PNI) might predict outcomes for critically ill patients. This study aimed to compare how well PNI, the SOFA score, and the APACHE-II score predict outcomes for non-Covid-19 ARDS patients in the ICU. This retrospective cross-sectional analytic observational study was conducted using medical records of non-Covid-19 ARDS patients admitted to the ICU of RSPAL Dr. Ramelan Surabaya from January 2022 to December 2024. A total of 564 patients met the inclusion criteria. Variables analyzed included PNI, SOFA score, APACHE-II score, mortality, duration of mechanical ventilation, and ICU length of stay. Statistical analyses included Spearman correlation, logistic regression, Receiver Operating Characteristic (ROC) curve analysis, and DeLong test with a significance level of p<0.05. The mortality rate among ARDS patients was 87.4%. SOFA, APACHE-II, and PNI were significantly associated with mortality in ARDS patients (p<0.001). The highest Area Under Curve (AUC) value was observed in APACHE-II (0.686), followed by SOFA (0.667) and PNI (0.652). DeLong test demonstrated no significant difference among the three predictors (p>0.05). The optimal cut-off values for SOFA, APACHE-II, and PNI were 7.5, 27.5, and 31.303, respectively. PNI demonstrated the highest sensitivity (70.8%), whereas APACHE-II showed the highest specificity (77.5%). Multivariate logistic regression showed that SOFA, APACHE-II, and PNI all independently and significantly predicted mortality in ARDS patients. All three measures demonstrated moderate ability to distinguish between survivors and non-survivors among non-Covid-19 ARDS patients in the ICU, with no statistically significant differences between them. Given its high sensitivity, PNI could serve as an early screening tool, whereas APACHE-II may be better suited for confirming mortality risk.
Keywords: ARDS; Prognostic Nutritional Index; SOFA; APACHE-II; ICU mortality.
How to cite this article: Khalid I, Fitriati M, Salinding A, Utomo B. Comparison of Prognostic Nutritional Index, SOFA Score, and APACHE II in Predicting Outcomes of Non-COVID-19 Acute Respiratory Distress Syndrome Patients in the ICU. Int J Drug Deliv Technol. 2026;16(5): 1197. DOI: 10.25258/ijddt.16.5.112
Source of support: Nil.
Conflict of interest: None