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Intensive Care Medicine

, Volume 32, Issue 11, pp 1839–1844 | Cite as

Validation of the SAPS 3 admission prognostic model in patients with cancer in need of intensive care

  • Márcio SoaresEmail author
  • Jorge I. F. Salluh
Original

Abstract

Objectives

To validate the SAPS 3 admission prognostic model in patients with cancer admitted to the intensive care unit (ICU).

Design

Cohort study.

Setting

Ten-bed medical–surgical oncologic ICU.

Patients and participants

Nine hundred and fifty-two consecutive patients admitted over a 3-year period.

Interventions

None.

Measurements and results

Data were prospectively collected at admission of ICU. SAPS II and SAPS 3 scores with respective estimated mortality rates were calculated. Discrimination was assessed by area under receiver operating characteristic (AUROC) curves and calibration by Hosmer–Lemeshow goodness-of-fit test. The mean age was 58.3 ± 23.1 years; there were 471 (49%) scheduled surgical, 348 (37%) medical and 133 (14%) emergency surgical patients. ICU and hospital mortality rates were 24.6% and 33.5%, respectively. The mean SAPS 3 and SAPS II scores were 52.3 ± 18.5 points and 35.3 ± 20.7 points, respectively. All prognostic models showed excellent discrimination (AUROC ≥ 0.8). The calibration of SAPS II was poor (p < 0.001). However, the calibration of standard SAPS 3 and its customized equation for Central and South American (CSA) countries were appropriate (p > 0.05). SAPS II and standard SAPS 3 prognostic models tended somewhat to underestimate the observed mortality (SMR > 1). However, when the customized equation was used, the estimated mortality was closer to the observed mortality [SMR = 0.95 (95% CI = 0.84–1.07)]. Similar results were observed when scheduled surgical patients were excluded.

Conclusions

The SAPS 3 admission prognostic model at ICU admission, in particular its customized equation for CSA, was accurate in our cohort of critically ill patients with cancer.

Keywords

SAPS 3 Intensive care unit Cancer Mortality Outcome Severity-of-illness scores 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Instituto Nacional de Câncer – INCACentro de Tratamento IntensivoRio de JaneiroBrazil
  2. 2.Intensive Care UnitHospital Barra D’OrRio de JaneiroBrazil

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