The relationship between prognostic and organ failure scoring systems such as APACHE II, SAPS II, MODS, SOFA and GCS and quantitative amino acid levels in intensive care unit patients

Abstract

Objective: this study aimed to investigate the relationship between the prognostic and organ failure scoring systems and quantitative amino acid levels in patients in the intensive care unit (ICU). Methods: a total of 45 patients over 45 years old, who were admitted to the ICU, were included in the study. Physical examinations of all patients were performed, and blood tests (including serum amino acids) were analyzed. Sequential organ failure assessment (SOFA), multiple organ dysfunction score (MODS), simplified acute physiology score II (SAPS II), acute physiology and chronic health evaluation II (APACHE II), and glasgow coma scale (GCS) scores of patients were calculated. Risk ratios were determined according to the mortality and organ failure scores of patients, and patients were grouped as high-risk and low risk. All these parameters were compared between these groups, and the relationship between amino acid levels and risk scores was evaluated. Statistical significance level was determined as a p-value of <0.05. Results: this study was carried out on 45 patients, 23 females and 22 males. The mean age of the patients was 74 +/- 11 years. In high-risk patients compared to low-risk group; methionine, ornithine, and phenylalanine levels according to APACHE II; beta-alanine, cystine, 3-methyl histidine, phenylalanine, and proline levels according to SAPS II; alanine, beta-alanine, phenylalanine, glycine, histidine, methionine, and ornithine levels according to GCS were significant different (p<0.05 for all). We found a significant positive correlation between the APACHE II score and beta alanine (r=0.466; p=0.001), citrulline (r=0.394; p=0.007), ethanolamine (r=0.366; p=0.013), histidine (r=0.353; p=0.017), 3-methyl histidine (r=0.450; p=0.002), ornithine (r=0.445; p=0.002), phenylalanine (r=0.548; p<0.001). There was a significant positive correlation between the SAPS II score and beta alanine (r=0.403; p=0.006), cystathionine (r=0.341; p=0.022), ethanolamine (r=0.356; p=0.017), 3-methyl histidine (r=0.402; p=0.006), ornithine (r=0.349; p=0.019), phenylalanine (r=0.525; p<0.001) and between the MODS score and alanine (r=0.340; p=0.022), beta alanine (r=0.407; p=0.006), cystathionine (r=0.352; p=0.018), ethanolamine (r=0.358; p=0.0169), histidine (r=0.495; p=0.001), 3-methyl histidine (r=0.407; p=0.006), methionine (r=0.462; p=0.001), ornithine (r=0.360; p=0.015), phenylalanine (r=0.621; p<0.001), proline (r=0.445; p=0.002). We found a significant positive correlation between the SOFA score and alanine (r=0.547; p<0.0019), beta-alanine (r=0.354; p=0.0179), arginine (r=0.423; p=0.004), cystathionine (r=0.423; p=0.004), ethanolamine (r=0.437; p=0.003), glycine (r=0.399; p=0.007), histidine (r=0.512; p<0.001), 3-methyl histidine (r=0.327; p=0.028), leucine (r=0.376; p=0.011), methionine (r=0.585; p<0.001), ornithine (r=0.467; p=0.001), phenylalanine (r=0.644; p<0.001), proline (r=0.523; p<0.001), threonine (r=0.371; p=0.012). Also, there was a significant negative correlation between GCS score and beta alanine (r=-0.390; p=0.008), ethanolamine (r=-0.364; p=0.014), glycine (r=-0.360; p=0.015), ornithine (r=-0.510; p=0.000), phenylalanine (r=-0.433; p=0.003). Conclusion: this study found significantly higher methionine, ornithine, phenylalanine, beta-alanine, cystine, 3-methyl histidine, proline, alanine, glycine, and histidine levels in patients with high-risk scores.