Score performance of SAPS 2 and SAPS 3 in combination with biomarkers IL-6, PCT or CRP

Abstract

We aimed to evaluate the effects of combining the Simplified-Acute-Physiology-Score (SAPS) 2 or the SAPS 3 with Interleukin-6 (IL-6) or Procalcitonin (PCT) or C-Reactive Protein (CRP) concentrations for predicting in-hospital mortality. Material and methods This retrospective study was conducted in an interdisciplinary 22-bed intensive care unit (ICU) at a German university hospital. Within an 18-month period, SAPS 2 and SAPS 3 were calculated for 514 critically ill patients that were admitted to the internal medicine department. To evaluate discrimination performance, the area under the receiver operating characteristic curves (AUROCs) and the 95% confidence intervals (95% CIs) were calculated for each score, exclusively or in combination with IL-6 or PCT or CRP. DeLong test was used to compare different AUROCs. Results The SAPS 2 exhibited a better discrimination performance than SAPS 3 with AUROCs of 0.81 (95% CI, 0.76-0.86) and 0.72 (95% CI, 0.66-0.78), respectively. Overall, combination of the SAPS 2 with IL-6 showed the best discrimination performance (AUROC 0.82; 95% CI, 0.77-0.87), albeit not significantly different from SAPS2. IL-6 performed better than PCT and CRP with AUROCs of 0.75 (95% CI, 0.69-0.81), 0.72 (95% CI, 0.66-0.77) and 0.65 (95% CI, 0.59-0.72), respectively. Performance of the SAPS 3 improved significantly when combined with IL-6 (AUROC 0.76; 95% CI, 0.69-0.81) or PCT (AUROC 0.73; 95% CI, 0.67-0.78). Conclusions Our analysis provided evidence that the risk stratification performance of the SAPS 3 and, to a lesser degree, also of the SAPS 2 can increase when combined with IL-6. A more

Enhancing SAPS-3 Predictive Accuracy with Initial, Peak, and Last Lactate Measurements in Septic Shock

“…Combining SAPS-3 with other biomarkers, such as IL-6 and lactate, as demonstrated previously [36,37], could significantly enhance the predictive accuracy of patient outcomes. In our study, first lactate proved to be the most effective predictor of outcomes when combined with SAPS-3, with an AUC of 80.6%.…”

Are patient volume and care level in teaching hospitals variables affecting clinical outcomes in adult intensive care units?

“…In a retrospective cohort study, Jahn et al showed that patients with higher SAPS 2 and 3 values at admission were more prone to death. (35) In addition to greater severity, H1 patients had a higher workload. The association between higher admission severity and higher nursing workload has been previously reported.…”

“…In a retrospective cohort study, Jahn et al showed that patients with higher SAPS 2 and 3 values at admission were more prone to death. ( 35 )…”

Comparison of Mortality Prediction Scores in Intermediate-Care Patients with Liver Cirrhosis at a German University Transplant Centre: A Prospective Study

“…A major concern about some popular disease severity assessment scores is the limited consideration of inflammatory processes and/or immune dysfunction that is particularly important in cirrhotic patients [42, 43]. Therefore, new markers that register oxidative stress or cell death might likely enhance score performance [44, 45].…”