Hernández CC, Meyer TM, López LC, Lemus CA, Carrillo RSC, Esponda PJG

Language: Spanish
References: 21
Page: 119-125
PDF size: 172.51 Kb.

ABSTRACT

Objective: To evaluate the performance of the SAPS III and SOFA prognostic scoring systems in the Intensive Care Unit of the Ángeles Pedregal Hospital (UTI-HAP). Material and methods: Retrospective cohort study conducted between January 1, 2016 and June 30, 2017. Mortality predicted with SAPS III and SOFA was calculated upon admission. The performance of both tests was graded by evaluating their discrimination (ability to distinguish between a patient who will live and one who will die; area under the curve) and their calibration power (comparison between observed mortality versus presented one; Lemeshow-Hosmer goodness-of-fit test). In the case of the SOFA scale, an assessment of sensitivity and specificity was made. Results: Our cohort was composed of 440 patients, with a mortality of 11.1%. SAPS III: presented an area under the curve of 0.852 ± 0.030; IC95% 0.793-0.912; p = 0.00. Lemeshow-Hosmer test: 0.852 ± 0.30; p = 0.362. SOFA: area under the curve of 0.859 ± 0.025; IC95% 0.810-0.908; p = 0.00. Sensitivity of 75% and specificity of 74%. Conclusions: Both SAPS III and SOFA showed an adequate performance in the prognostic assessment of the patients of the UTI-HAP.

REFERENCES

1. Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE-acute physiology and chronic health evaluation: A physiologically based classification system. Crit Care Med. 1981; 9 (8): 591-597.

2. Le Gall JR, Loirat P, Alperovitch A, Glaser P, Granthil C, Mathieu D et al. A simplified acute physiology score for ICU patients. Crit Care Med. 1984; 12 (11): 975-977.

3. Lemeshow S, Teres D, Pastides H, Avrunin JS, Steingrub JS. A method for predicting survival and mortality of ICU patients using objectively derived weights. Crit Care Med. 1985; 13 (7): 519-525.

4. Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med. 1998; 26 (11): 1793-800.

5. Russell JA. Assessment of Severity of Illness. In: Hall JB, Schmidt GA, Wood LD. Principles of critical care. Part 1. An overview of the approach to and organization of critical care. Chapter 13. 4th ed. McGraw-Hill Inc.; 2015. pp 83-96..

6. Mata VJ. Escalas pronósticas en la unidad de terapia intensiva. Rev Asoc Mex Med Crit y Ter Int. 2012; 26 (4): 234-241.

7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. Apache II: a severity of disease classification system. Crit Care Med. 1985; 13 (10): 818-829.

8. Knaus WA, Wagner DP, Draper EA, Zimerman JE, Bergner M, Bastos PG et al. The Apache III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991; 100 (6): 1619-1636.

9. Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today’s critically ill patients. Crit Care Med. 2010; 34 (5): 1297-1310.

10. Teres D, Lemeshow S, Avrunin JS, Pastides H. Validation of the mortality prediction model for ICU patients. Crit Care Med. 1987; 15 (3): 208-213.

11. Lemeshow S, Teres D, Avrunin JS, Gage RW. Refining intensive care unit outcome prediction by using changing probabilities of mortality. Crit Care Med. 1988; 16 (5): 470-477.

12. Lemeshow S, Teres D, Klar J, Avrunin JS, Gehlbach SH, Rapoport J. Mortality probability models (MPM II) based on an international cohort of intensive care unit patients. JAMA. 1993; 270 (20): 2.478-2.486.

13. Lemeshow S, Klar J, Teres D, Avrunin JS, Gehlbach SH, Rapoport J et al. Mortality probability models for patients in the intensive care unit for 48 or 72 hours: a prospective, multicenter study. Crit Care Med. 1994; 22 (9): 1.351-1.358.

14. Le Gall JR, Lemeshow S, Saulnier F. A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA. 1993; 270 (24): 2.957-2.963.

15. Moreno RP, Metnitz PG, Almeida E, Jordan B, Bauer P, Campos RAK et al. SAPS 3-From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med. 2005; 31 (10): 1345-1355.

16. Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001; 286 (14): 1754-1758.

17. The SAPS III Outcomes Research Group (SORG). [Internet]. Portugal: [actualizado n.d.; citado 25 octubre 2018]. SAPS 3 Admission Score Sheet (MS Excel). Disponible en: http://www.saps3.org/resources-downloads/user-agreement/downloads/.

18. López-Caler C, García-Delgado M, Carpio-Sanz J, Álvarez-Rodríguez J, Aguilar-Alonso E, Castillo-Lorente E et al. External validation of the Simplified Acute Physiology Score (SAPS) 3 in Spain. Med Intensiva. 2013; 38 (5): 288-296.

19. Williams JM, Greenslade JH, Chu K, Brown AF, Lipman J. Severity scores in emergency department patients with presumed infection: a prospective validation study. Crit Care Med. 2016; 44 (3): 539-547.

20. Shabir A, Maqbool M. Accuracy of SOFA score in predicting outcome in medical patients with various diagnosis in intensive care unit in a tertiary care hospital in Northern India. Int J Contemp Med Res. 2017; 4 (1): 168-172.

21. Arts DG, de Keizer NF, Vroom MB, de Jonge E. Reliability and accuracy of Sequential Organ Failure Assessment (SOFA) scoring. Crit Care Med. 2005; 33 (9): 1988-1993.