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Órgano Oficial del Hospital Angeles Health System

2005, Number 4

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Acta Med 2005; 3 (4)

Validation of a predictive mathematical model of mortality in the intensive care unit of the Angeles Mocel Hospital

Noriega PA, Morales CI, Sánchez VLD, Pizaña DA

Language: Spanish
References: 22
Page: 229-233
PDF size: 58.70 Kb.


ABSTRACT

The challenge of adopting prognostic assessments of mortality is fundamental for the evaluation of the quality of attention and to rationalize resources. There are no national studies that inform on the standard mortality ratio (SMR) of the hospitals that can allow for the assessment of the accomplishment in intensive care units (ICU). Objectives: Determine the discrimination and the calibration of the APACHE II model and the SMR in the ICU of the Mocel Hospital during the year 2004. Material and methods: Observational, longitudinal and homodemic study. All the patients admitted into the ICU during the study period. Site: mixed ICU of a general private hospital. Period: March 1, 2004 to February 28, 2005. Variables: Demographic and APACHE II. Statistics: Descriptive and inferential, SMR, discrimination with area under the curve (ROC), calibration with the Hosmer-Lemeshow χ2 and measurement of the confidence interval according to Rapoport. Results: A total of 332 patients, 140 women (42.2%) and 192 men (57.8%), age 63 ± 17 (16-95 years). The SMR was 0.82 (CI95% 0.63–1.01). The area under the ROC curve was 0.828 ± 0.027 (p ‹ 0.001) and the χ2H-L was 5.041 (p = NS). Conclusion: The APACHE II model applied to the studied population showed adequate discrimination and appropriate calibration for which it can be used as an indicator of quality of attention. The SMR was less than 1 translating into an excellent quality of medical attention.


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