Skip to main content

Advertisement

SpringerLink
Log in

Ward mortality after ICU discharge: a multicenter validation of the Sabadell score

  • Original
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Background

Tools for predicting post-ICU patients’ outcomes are scarce. A single-center study showed that the Sabadell score classified patients into four groups with clear-cut differences in ward mortality.

Objective and design

To validate the Sabadell score using a prospective multicenter approach.

Setting

Thirty-one ICUs in Spain.

Patients and methods

All patients admitted in the 3-month study period. We recorded variables at ICU admission (age, sex, severity of illness, and do-not-resuscitate orders), during the ICU stay (ICU-specific treatments, ICU-acquired infection, and acute renal failure), and at ICU discharge (Sabadell score). Statistical analyses included one-way ANOVA and multiple regression analysis with ward mortality as the dependent variable.

Results

We admitted 4,132 patients (mean age 61.5 ± 16.7 years) with mean predicted mortality of 23.8 ± 22.7%; 545 patients (13%) died in the ICU and 3,587 (87%) were discharged to the ward. Overall ward mortality was 6.7%; ward mortality was 1.5% (36/2,422) in patients with score 0 (good prognosis), 9% (64/725) in patients with score 1 (long-term poor prognosis), 23% (79/341) in patients with score 2 (short-term poor prognosis), and 64% (63/99) in patients with score 3 (expected hospital death). Variables associated with ward mortality in the multivariate analysis were predicted risk of death (OR 1.016), ICU readmission (OR 5.9), Sabadell score 1 (OR 4.7), Sabadell score 2 (OR 15.7), and Sabadell score 3 (OR 107.2).

Conclusion

We confirm the ability of the Sabadell score at ICU discharge to define four groups of patients with very different likelihoods of hospital survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Angus DC, Carlet J, 2002 Brussels Roundtable Participants (2003) Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Med 29:368–377

    PubMed  Google Scholar 

  2. Frick S, Uehlinger DE, Zuercher Zenklusen RM (2003) Medical futility: predicting outcome of intensive care unit patients by nurses and doctors—a prospective comparative study. Crit Care Med 31:456–461

    Article  PubMed  Google Scholar 

  3. Ball C, Kirkby M, Williams S (2003) Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study. BMJ 327:1014–1017

    Article  PubMed  Google Scholar 

  4. Rué M, Artigas A, Alvarez M, Quintana S, Valero C (2000) Performance of the mortality probability models in assessing severity of illness during the first week in the intensive care unit. Crit Care Med 28:2819–2824

    Article  PubMed  Google Scholar 

  5. Gajic O, Malinchoc M, Comfere TB, Harris MR, Achouiti A, Yilmaz M, Schultz MJ, Hubmayr RD, Afessa B, Farmer JC (2008) The stability and workload index for transfer score predicts unplanned intensive care unit patient readmission: initial development and validation. Crit Care Med 36:676–682

    Article  PubMed  Google Scholar 

  6. Iapichino G, Morabito A, Mistraletti G, Ferla L, Radrizzani D, Reis Miranda D (2003) Determinants of post-intensive care mortality in high-level treated critically ill patients. Intensive Care Med 29:1751–1756

    Article  PubMed  Google Scholar 

  7. Smith L, Orts CM, O’Neil I, Batchelor AM, Gascoigne AD, Baudouin SV (1999) TISS and mortality after discharge from intensive care. Intensive Care Med 25:1061–1065

    Article  CAS  PubMed  Google Scholar 

  8. Moreno R, Miranda DR, Matos R, Fevereiro T (2001) Mortality after discharge from intensive care: the impact of organ system failure and nursing workload use at discharge. Intensive Care Med 27:999–1004

    Article  CAS  PubMed  Google Scholar 

  9. Daly K, Beale R, Chang RWS (2001) Reduction in mortality after inappropriate early discharge from intensive care unit: logistic regression triage model. BMJ 322:1274–1276

    Article  CAS  PubMed  Google Scholar 

  10. Azoulay E, Adrie C, De Lassence A, Pochard F, Moreau D, Thiery G, Cheval C, Moine P, Garrouste-Orgeas M, Alberti C, Cohen Y, Timsit JF (2003) Determinants of postintensive care unit mortality: a prospective multicenter study. Crit Care Med 31:428–432

    Article  PubMed  Google Scholar 

  11. Fernandez R, Baigorri F, Navarro G, Artigas A (2006) A modified McCabe score for stratification of patients after ICU discharge: the Sabadell score. Crit Care 10:R179

    Article  PubMed  Google Scholar 

  12. Palencia E, Rico P, Diaz D, Martinez A, Villanova M, Bueno B (2009) Validation of the Sabadell score. Intensive Care Med 35(Suppl 1):S177

    Google Scholar 

  13. Afessa B, Keegan MT (2007) Predicting mortality in intensive care unit survivors using a subjective scoring system. Crit Care 11:109

    Article  PubMed  Google Scholar 

  14. Palencia E, Rico P, Diaz D, Martinez A, Villanova M, Bueno B, Andrade G, Heras G, Rodriguez M (2009) Sabadell score to predict post-ICU discharge hospital mortality. Intensive Care Med 35(Suppl 1):177

    Google Scholar 

  15. McCabe WR, Jackson GG (1962) Gram negative bacteremia. I. Etiology and ecology. Arch Intern Med 110:845–847

    Google Scholar 

  16. Rivera-Fernandez R, Sanchez-Cruz JJ, Abizanda-Campos R, Vazquez-Mata G (2001) Quality of life before intensive care unit admission and its influence on resource utilization and mortality rate. Crit Care Med 29:1701–1709

    Article  CAS  PubMed  Google Scholar 

  17. Ferrand E, Lemaire F, Regnier B, Kuteifan K, Badet M, Asfar P, Jaber S, Chagnon JL, Renault A, Robert R, Pochard F, Herve C, Brun-Buisson C, Duvaldestin P, French RESSENTI Group (2003) Discrepancies between perceptions by physicians and nursing staff of intensive care unit end-of-life decisions. Am J Respir Crit Care Med 167:1310–1315

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors declare that there was no financial support provided for this work.

Author information

Authors and Affiliations

  1. CIBER Enfermedades Respiratorias, ICU, Hospital Sant Joan de Deu, Fundació Althaia, Manresa, Spain

    Rafael Fernandez

  2. H.U. Reina Sofia, Cordoba, Spain

    Jose Manuel Serrano

  3. H. de Cruces, Baracaldo, Spain

    Isabel Umaran

  4. H.G.U. Castelló, Castelló, Spain

    Ricard Abizanda

  5. H.G.U. JM Morales Messeguer, Murcia, Spain

    Andres Carrillo

  6. H. General Yague, Burgos, Spain

    Mª Jesus Lopez-Pueyo

  7. C.H.U. de A Coruña, A Coruña, Spain

    Pedro Rascado

  8. H.U. La Fe, Valencia, Spain

    Begoña Balerdi

  9. H.U. Marques de Valdecilla, Santander, Spain

    Borja Suberviola

  10. H. Virgen de la Salud, Toledo, Spain

    Gonzalo Hernandez

Authors
  1. Rafael Fernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jose Manuel Serrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Isabel Umaran
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ricard Abizanda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andres Carrillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mª Jesus Lopez-Pueyo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Pedro Rascado
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Begoña Balerdi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Borja Suberviola
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gonzalo Hernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rafael Fernandez.

Additional information

For the Sabadell Score Study Group (see Appendix).

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 41 kb)

Appendix

Appendix

The Sabadell Score Study Group members are Ana Isabel Tizon (H. Xeral Cies, Vigo, Spain), Javier Gonzalez (C. H. de Salamanca, Salamanca, Spain), Pablo Monedero (Clinica U. de Navarra, Navarra, Spain), Manuela Garcia Sanchez (H. U. Virgen Macarena, Sevilla, Spain), Mª Victoria de la Torre (H. Virgen de la Victoria, Malaga, Spain), Pedro Ibañez (H. Son Llatzer, Mallorca, Spain), Fernando Frutos (H. U. de Getafe, Getafe, Spain; CIBER Enfermedades Respiratorias), Frutos del Nogal (H. Severo Ochoa, Leganes, Spain), Mª Jesus Gomez (H. G. U. Reina Sofia, Murcia, Spain), Alfredo Marcos (H. Virgen de la Concha, Zamora, Spain), Victoria Lacueva (H. de Sagunt, Sagunt, Spain), Rosa Mª Catalan (C. H. de Vic, Vic, Spain), Lluis Cabre (H. de Barcelona SCIAS, Barcelona, Spain), Antonio Santos (C. H. U. de Santiago de Compostela, Santiago de Compostela, Spain), Paula Vera (H. Sant Joan de Reus, Reus, Spain), Mª Jose Gutierrez (H. San Agustin, Aviles, Spain), Jose Felipe Solsona (H. del Mar, Barcelona, Spain), Jose Manuel Añon (H. Virgen de la Luz, Cuenca, Spain), Enrique Fernandez-Mondejar (H. Virgen de las Nieves, Granada, Spain), Ramon Fernandez-Cid (H. Mateu Orfila, Menorca, Spain), Emilio Curiel [H. U. Carlos Haya (Hospital Civil), Malaga, Spain], Vicente Gomez-Tello (Clinica Moncloa, Madrid, Spain).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fernandez, R., Serrano, J.M., Umaran, I. et al. Ward mortality after ICU discharge: a multicenter validation of the Sabadell score. Intensive Care Med 36, 1196–1201 (2010). https://doi.org/10.1007/s00134-010-1825-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-010-1825-5

Keywords

Search

Navigation