Objective: This preliminary study aims (1) at validating the use of Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system in cardiac patients admitted to the intensive cardiac care unit (ICCU) for prediction of the risk for mortality, (2) to evaluate the use of a modified APACHE II (mAPACHE II) with addition of the scores related to urinary levels of oxidative stress parameters in prediction of the risk for mortality. Design: Hospital based prospective study. Setting: Tertiary care hospital in South India. Methods: Cardiac patients (n=100) admitted to the intensive cardiac care unit between the age of 18-77 years were enrolled. APACHE II score was calculated. The predicted mortality was calculated on the basis of this score. Urinary malondialdehyde (MDA) and ceruloplasmin (Cp) levels were analyzed and mAPACHE II was calculated. Results: The mean APACHE score was 11 ± 4.14. The ICCU mortality rate within 24 hours after admission was 8%. The area under the receiver operating curve (ROC) for APACHE II score was found to be 0.8 indicating good discrimination and for mAPACHE II score was 0.7 indicating moderate discrimination. Conclusion: APACHE II scoring system has a good discrimination when applied to cardiac patients. However, mAPACHE II also shows moderate discrimination when applied to these patients.