Materias Investigacion::Ciencias de la Salud::Medicina clínica SAPS (Simplified acute physiology score) Materias Investigacion::Ciencias de la Salud::Medicina de urgencia y cuidados intensivos
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Lucena JF, Alegre F, Martinez-Urbistondo D, Landecho MF, Huerta A, et al. Performance of SAPS II and SAPS 3 in Intermediate Care. PLoS ONE 2013;8(10):e77229.
Objective: The efficacy and reliability of prognostic scores has been described extensively for intensive care, but
their role for predicting mortality in intermediate care patients is uncertain. To provide more information in this field,
we have analyzed the performance of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 in a single center
intermediate care unit (ImCU).
Materials and Methods: Cohort study with prospectively collected data from all patients admitted to a single center
ImCU in Pamplona, Spain, from April 2006 to April 2012. The SAPS II and SAPS 3 scores with respective predicted
mortality rates were calculated according to standard coefficients. Discrimination was evaluated by calculating the
area under receiver operating characteristic curve (AUROC) and calibration with the Hosmer-Lemeshow goodness of
fit test. Standardized mortality ratios (SMR) with 95% confidence interval (95% CI) were calculated for each model.
Results: The study included 607 patients. The observed in-hospital mortality was 20.1% resulting in a SMR of 0.87
(95% CI 0.73-1.04) for SAPS II and 0.56 (95% CI 0.47-0.67) for SAPS 3. Both scores showed acceptable
discrimination, with an AUROC of 0.76 (95% CI 0.71-0.80) for SAPS II and 0.75 (95% CI 0.71- 0.80) for SAPS 3.
Calibration curves showed similar performance based on Hosmer-Lemeshow goodness of fit C-test: (X2=12.9,
p=0.113) for SAPS II and (X2=4.07, p=0.851) for SAPS 3.
Conclusions: Although both scores overpredicted mortality, SAPS II showed better discrimination for patients
admitted to ImCU in terms of SMR.