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ISSN 2448-8909 (Print)

2007, Number 3

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Med Crit 2007; 21 (3)

Comparison of the performance of two mortality predictive models: SAPS3 vs APACHE II, in a Mexican ICU

Aguirre SCA, Cerón DUW, Sierra UA

Language: Spanish
References: 20
Page: 119-124
PDF size: 124.67 Kb.


ABSTRACT

Introduction: The adoption of a predictive model requires a local validation work in order to ensure that its application is adjusted to the attended population.
Objective: To compare the performance of SAPS-3 and APACHE-II to predict in-hospital death.
Patients and methods: Inclusion criteria: patients who were admitted into the ICU from January until May 2006. Exclusion criteria: re-admittances, coronary patients, cardiac surgery patients, voluntary discharge, discharge to another hospital. Probability of death was calculated with both systems, with the UCI admittance data. The performance of the models was evaluated in 2 areas: a) discriminative capability and b) calibration. The discriminative capability is expressed by the AUC (area under the curve) ROC (receptor operative characteristic), and the calibration is analyzed through a Goodness of fit (Lemeshow and Hosmer), as well as the correlation between predicted and actual mortality for each group divided by deciles. A statistically significant probability of error (p) was considered of ‹ 0.05 for the AUC, and an adequate calibration was considered when the C statistic tool was less than the critical χ2 for 8 gL.
Results: 110 registered patients, 15 of them were excluded, 95 included registries.

SAPS 3 APACHE II «p»
AUC * 0.86 ± 0.018 0.79 ± 0.015 ‹ 0.01
«C».
Lemeshow 6.54, p › 0.1 16.95, p ‹ 0.05
and Hosmer
* AUC (area under the curve) ± EE.
Conclusion: SAPS 3 showed a better performance than APACHE II.


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