Performance of SAPS3, compared with APACHE II and SOFA, to predict hospital mortality in a general ICU in Southern Europe
Keywords: 
Acute Physiology and Chronic Health Evaluation II
ICU outcome
ICU score
Outcome assessment (healthcare)
Severity of illness index
Simplified Acute Physiology Score 3
Issue Date: 
2009
Publisher: 
Wolters Kluwer
ISSN: 
0265-0215
Citation: 
Mbongo, Cissé-Luc; Monedero, Pablo; Guillen-Grima, Francisco; Yepes, Maria J; Vives, Marc; Echarri, Gemma. Performance of SAPS3, compared with APACHE II and SOFA, to predict hospital mortality in a general ICU in Southern Europe. European Journal of Anaesthesiology 26(11):p 940-945, November 2009. | DOI: 10.1097/EJA.0b013e32832edadf
Abstract
Background and objective Simplified Acute Physiology Score (SAPS3) has not been validated in Southern European countries. The purpose of this study was to validate the ability of SAPS3 to predict hospital mortality in adult patients in an interdisciplinary intensive care unit in Southern Europe, compared with Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA). Methods This is a cohort study of 864 patients with a prospective collection of SAPS3 and SOFA variables and retrospective analysis of APACHE II in a mixed intensive care unit at a teaching hospital in Spain throughout 2006. The performance of the systems was determined by examining their discrimination and calibration. Results The discrimination of SAPS3 was excellent, with an area under the receiver operating characteristic curve of 0.916, similar to APACHE II (area under the receiver operating characteristic curve = 0.893) or SOFA (area under the receiver operating characteristic curve = 0.846). The calibration was good for SAPS3 but insufficient for APACHE II. Hospital death rates were lower than those that were predicted by the models. Conclusion Our data demonstrate a better calibration of SAPS3 than APACHE II. Calibration was sufficient only for SAPS3. Hospital mortality was lower than predicted by both models. The discrimination of SAPS3 is excellent, and, when it is customized for Southern Europe, SAPS3 accurately predicts mortality risk in our adult mixed-case ICU.

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