Applicability of the simplified acute physiology score (SAPS 3) in Brazilian hospitals.
نویسندگان
چکیده
BACKGROUND AND OBJECTIVES The SAPS 3 (Simplified Acute Physiology Score 3) prognostic system is composed of 20 parameters, represented by an acute physiology score and assessment of the previous status, aimed at establishing a predictive mortality index for patients admitted to intensive care units (ICU). The objective of this study was to validate this system and determine its discriminatory power in surgical patients in Brazil. METHODS This is a prospective study undertaken in two surgical ICUs of two different hospitals over a one-year period; patients younger than 16 years, who stay at the ICU for less than 24 hours, readmitted to the unit, and those admitted for dialysis were excluded from the study. The predictive ability of the SAPS 3 index to differentiate survivors and non-survivors was determined by the ROC curve and calibration by the Hosmer-Lemeshow goodness-of-fit test. RESULTS One thousand three-hundred and ten patients were included in the study. Gastrointestinal surgeries predominated (34.9%). Eighteen was the lower SAPS 3 index and the highest was 154, with a mean of 48.5 +/- 18.1. The predicted and real hospital mortality was 10.3% and 10.8%, respectively; the standardized mortality ratio (SMR) was 1.04 (95%CI = 1.03-1.07). Calibration by the Hosmer and Lemeshow method showed X(2) = 10.47 p = 0.234. The SAPS 3 score that better discriminated survivors and non-survivors was 57, with sensitivity of 75.8% and specificity 86%. Among the patients with SAPS 3 index higher than 57, 73.5% did not survive versus 26.5% who survived (OR= 1.32, 95%CI 1.23-1.42, p < 0.0001). CONCLUSIONS The SAPS 3 system is valid for the Brazilian population of surgical patients, being a useful indicator of critical patients and to determine greater care in this group.
منابع مشابه
Which of Simplified Acute Physiology Score-III or Mortality Probability Model-III scoring systems in prediction of mortality of non-traumatic patients is superior?
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BACKGROUND The Simplified Acute Physiology Score (SAPS) 3 has recently been developed, but not yet validated in surgical intensive care unit (ICU) patients. We compared the performance of SAPS 3 with SAPS II and the Acute Physiology and Chronic Health Evaluation (APACHE) II score in surgical ICU patients. METHODS Prospectively collected data from all patients admitted to a German university h...
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ورودعنوان ژورنال:
- Revista brasileira de anestesiologia
دوره 60 1 شماره
صفحات -
تاریخ انتشار 2010