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Comparison of three severity scores for critically ill cancer patients

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Abstract

Objective

To compare three scoring systems, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Simplified Acute Physiology Score (SAPS) II and a modified Mortality Probability Model II (ICU cancer mortality model, ICMM) for their prognostic value for mortality during hospital stay in a group of cancer patients admitted to a medical ICU.

Design

Prospective cohort study.

Setting

Medical ICU of a tertiary care hospital.

Patients

Two hundred forty-two consecutive cancer patients admitted to the ICU.

Measurements and results

Variables included in APACHE II, SAPS II and the ICMM scores as well as demographic data were assessed during the first 24 h of stay in the ICU. Hospital mortality was measured; it was 44%. Calibration for all three scoring systems was acceptable, SAPS II yielded a significantly superior discrimination between survivors and non-survivors. The areas under the receiver operating characteristic curves were 0.776 for APACHE II, 0.825 for SAPS II and 0.698 for the ICMM.

Conclusion

The SAPS II was superior to APACHE II and ICMM. The newly developed ICMM does not improve mortality prediction in critically ill cancer patients.

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Authors and Affiliations

  1. Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Peter Schellongowski, Friederike Traunmüller, Klaus Laczika, Gottfried J. Locker, Michael Frass & Thomas Staudinger

  2. Institute for Medical Statistics, University of Vienna, Schwarzspanierstrasse 17, 1090, Vienna, Austria

    Michael Benesch & Thomas Lang

  3. Department of Internal Medicine IV, University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Christian Zauner

Authors
  1. Peter Schellongowski
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  2. Michael Benesch
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  3. Thomas Lang
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  4. Friederike Traunmüller
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  5. Christian Zauner
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  6. Klaus Laczika
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  7. Gottfried J. Locker
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  8. Michael Frass
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  9. Thomas Staudinger
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Corresponding author

Correspondence to Thomas Staudinger.

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Schellongowski, P., Benesch, M., Lang, T. et al. Comparison of three severity scores for critically ill cancer patients. Intensive Care Med 30, 430–436 (2004). https://doi.org/10.1007/s00134-003-2043-1

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  • DOI: https://doi.org/10.1007/s00134-003-2043-1

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