Is SAPS 3 better than APACHE II at predicting mortality in critically ill transplant patients?
Clinics
;
68(2): 153-158, 2013. ilus, tab
Article
in English
| LILACS
| ID: lil-668800
ABSTRACT
OBJECTIVES:
This study compared the accuracy of the Simplified Acute Physiology Score 3 with that of Acute Physiology and Chronic Health Evaluation II at predicting hospital mortality in patients from a transplant intensive care unit.METHOD:
A total of 501 patients were enrolled in the study (152 liver transplants, 271 kidney transplants, 54 lung transplants, 24 kidney-pancreas transplants) between May 2006 and January 2007. The Simplified Acute Physiology Score 3 was calculated using the global equation (customized for South America) and the Acute Physiology and Chronic Health Evaluation II score; the scores were calculated within 24 hours of admission. A receiver-operating characteristic curve was generated, and the area under the receiver-operating characteristic curve was calculated to identify the patients at the greatest risk of death according to Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores. The Hosmer-Lemeshow goodness-of-fit test was used for statistically significant results and indicated a difference in performance over deciles. The standardized mortality ratio was used to estimate the overall model performance.RESULTS:
The ability of both scores to predict hospital mortality was poor in the liver and renal transplant groups and average in the lung transplant group (area under the receiver-operating characteristic curve = 0.696 for Simplified Acute Physiology Score 3 and 0.670 for Acute Physiology and Chronic Health Evaluation II). The calibration of both scores was poor, even after customizing the Simplified Acute Physiology Score 3 score for South America.CONCLUSIONS:
The low predictive accuracy of the Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores does not warrant the use of these scores in critically ill transplant patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Health Status Indicators
/
Kidney Transplantation
/
Liver Transplantation
/
Lung Transplantation
/
Pancreas Transplantation
/
Hospital Mortality
Type of study:
Etiology study
/
Prognostic study
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2013
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital de Clínicas de Porto Alegre/BR
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