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Critical Care

, 12:P502 | Cite as

Assessment of the performance of the SAPS 3, SAPS II, and APACHE II prognostic models in a surgical ICU

  • C Krauss
  • Y Sakr
  • A Amaral
  • A Rea-Neto
  • M Specht
  • K Reinhart
  • G Marx
Poster presentation

Keywords

Visual Inspection Comparative Performance Hospital Mortality Operator Curve Prognostic Model 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

The aim of this study was to assess the comparative performance of the SAPS 3 score with that of the APACHE II and SAPS II scores in surgical ICU patients.

Methods

In a cohort, observational study in a 51-bed postoperative ICU of a university hospital, we included all consecutive patients admitted to the ICU between August 2004 and December 2005. The SAPS 3 score was retrospectively calculated from prospectively collected data. The probability of ICU mortality was calculated for SAPS II, APACHE II, adjusted APACHE II (adjAPACHE II), SAPS 3, and customized SAPS 3 for West Europe (C-SAPS3 (Eu)) using standard formulas. A first-level customization was performed using logistic regression on the original scores, and the corresponding probability of ICU death was calculated for the customized scores (C-SAPS II, C-SAPS 3, and C-APACHE II).

Results

The study group constituted 1,851 patients; 1,173 males (63.4%) and 678 females (36.6%), mean age 62 years. Patients were mostly admitted after cardiac surgery (26.4%). Gastrointestinal, neurosurgery, vascular, and trauma surgeries contributed to 18.7%, 8.1%, 5.7%, and 7.5%. The overall ICU and hospital mortality rates were 6.4% and 9%. Hosmer and Lemeshow (H–L) statistics showed poor calibration for SAPS II, APACHE II, adjAPACHE II, SAPS 3, and C-SAPS 3 (Eu) (H–L C-statistics and H-statistics: P > 0.05), whereas C-SAPS II, C-APACHE II, and C-SAPS 3 showed good calibration. Discrimination was generally good for all models (area under the receiver operator curve (aROC) ranged from 0.78 (C-APACHE II score) to 0.89 (C-SAPS 3). APACHE II and C-APACHE II scores had significantly lower aROC compared with other scores. C-SAPS 3 score appears to have the best calibration curve by visual inspection.

Conclusion

In this group of surgical ICU patients the performance of the SAPS 3 score was similar to that of the APACHE II and SAPS II scores. Customization improved calibration of all prognostic models.

Copyright information

© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.

Authors and Affiliations

  • C Krauss
    • 1
  • Y Sakr
    • 1
  • A Amaral
    • 2
  • A Rea-Neto
    • 1
  • M Specht
    • 1
  • K Reinhart
    • 1
  • G Marx
    • 1
  1. 1.Friedrich Schiller University HospitalJenaGermany
  2. 2.Hospital Brasilia, Rede ESHOBrasiliaBrazil

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