Validation of the Simplified Acute Physiology Score 3 Scoring System in a Korean Intensive Care Unit
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초록
Purpose: The Simplified Acute Physiology Score (SAPS) 3 was recently proposed to reflect contemporary changes in intensive care practices. SAPS 3 features customized equations for the prediction of mortality in different geographic regions. However, the usefulness of SAPS 3 and its customized equation (Australasia SAPS 3) have never been externally validated in Korea. This study was designed to validate SAPS 3 and Australasia SAPS 3 for mortality prediction in Korea. Materials and Methods: A retrospective analysis of the prospective intensive care unit (ICU) registry was conducted in the medical ICU of Samsung Medical Center. Calibration and discrimination were determined by the Hosmer-Lemeshow test and area under the receiver operating characteristic (aROC) curve from 633 patients. Results: The mortalities (%) predicted by SAPS 3, Australasia SAPS 3, and SAPS II were 42 ± 28, 39 ± 27 and 37 ± 31, respectively. The calibration of SAPS II was poor (p = 0.003). SAPS 3 and Australasia SAPS 3 were appropriate (p > 0.05). The discriminative power of all models yielded aROC values less than 0.8. Conclusion: In Korea,mortality rates predicted using general SAPS 3 and Australasia SAPS 3 exhibited good calibration and modest discrimination. However, Australasia SAPS 3 did not improve the mortality prediction. To better predict mortality in Korean ICUs, a new equation may be needed specifically for Korea.
Abstract
Purpose: The Simplified Acute Physiology Score (SAPS) 3 was recently proposed to reflect contemporary changes in intensive care practices. SAPS 3 features customized equations for the prediction of mortality in different geographic regions. However, the usefulness of SAPS 3 and its customized equation (Australasia SAPS 3) have never been externally validated in Korea. This study was designed to validate SAPS 3 and Australasia SAPS 3 for mortality prediction in Korea. Materials and Methods: A retrospective analysis of the prospective intensive care unit (ICU) registry was conducted in the medical ICU of Samsung Medical Center. Calibration and discrimination were determined by the Hosmer-Lemeshow test and area under the receiver operating characteristic (aROC) curve from 633 patients. Results: The mortalities (%) predicted by SAPS 3, Australasia SAPS 3, and SAPS II were 42 ± 28, 39 ± 27 and 37 ± 31, respectively. The calibration of SAPS II was poor (p = 0.003). SAPS 3 and Australasia SAPS 3 were appropriate (p > 0.05). The discriminative power of all models yielded aROC values less than 0.8. Conclusion: In Korea,mortality rates predicted using general SAPS 3 and Australasia SAPS 3 exhibited good calibration and modest discrimination. However, Australasia SAPS 3 did not improve the mortality prediction. To better predict mortality in Korean ICUs, a new equation may be needed specifically for Korea.
참고문헌 (13)
- Metnitz B, "ASDI Study Group. Austrian validation and customization of the SAPS 3 Admission Score", Intensive Care Med, 35, pp.616~622 (2009)
- Knaus WA, "APACHE II: a severity of disease classification system", Crit Care Med, 13, pp.818~829 (1985)
- Knaus WA, "The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults", Chest, 100, pp.1619~1636 (1991)
- Le Gall JR, "A new Simplified Acute Physiology Score (SAPS II) based on a European", North American multicenter study, 1993, pp.270, 2957~2963
- Lemeshow S, "Rapoport J. Mortality Probability Models (MPM II) based on an international cohort of intensive care unit patients", JAMA, 270, pp.2478~2486 (1993)
- Groeger JS, "Multicenter outcome study of cancer patients admitted to the intensive care unit: a probability of mortality model", J Clin Oncol, 16, pp.761~770 (1998)
- Moreno RP, "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, 31, pp.1345~1355 (2005)
- Soares M, "Validation of the SAPS 3 admission prognostic model in patients with cancer in need of intensive care", Intenpatients sive Care Med, 32, pp.1839~1844 (2006)
- Ledoux D, "SAPS 3 admission score: an external validation in a general intensive care population", Intensive Care Med, 34, pp.1873~1877 (2008)
- Metnitz PG, "Prognostic performance and customization of the SAPS II: results of a multicenter Austrian study. Simplified Acute Physiology Score", Intensive Care Med, 25, pp.192~197 (1999)
- Metnitz PG, "SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description", Intensive Care Med, 31, pp.1336~1344 (2005)
- Aggarwal AN, "Performance of standard severity scoring systems for outcome prediction in patients admitted to a respiratory intensive care unit in North India", Respirology, 11, pp.196~204 (2006)
- Teres D, "As American as apple pie and APACHE. Acute Physiology and Chronic Health Evaluation", Crit Care Med, 26, pp.1297~1298 (1998)