The performance of SAPS II in a cohort of patients admitted to 99 Italian ICUs: Results from GiViTI

Apolone, Giovanni; Bertolini, Guido; D’Amico, Roberto; Iapichino, G.; Cattaneo, Alessandro; Salvo, Gian Luca De; R, Melotti

doi:10.1007/bf01709553

Cited by 111 publications

(42 citation statements)

References 22 publications

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“…We found a similar pattern in Austrian ICU patients [3]. Customization of a general severity of illness score by deriving a new logistic regression equation has been advocated as being useful in these circumstances [2,4,5]. However, Moreno et al [2] have demonstrated that, although customization can improve the overall predictive performance of a model, it does not solve other model-related problems, especially inhomogeneity across patient subgroups.…”

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confidence: 73%

Ratios of observed to expected mortality are affected by differences in case mix and quality of care

et al. 2000

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Today's severity scoring systems, such as the SAPS II, are limited by not measuring (and adjusting for) a profound part of what constitutes case mix. Changes in the distribution of patient characteristics (known and unknown) therefore affect prognostic accuracy. First-level customization was not able to solve all these problems. Using O/E ratios for quality of care comparisons one must therefore be critical when using these data and should search for possible confounding factors. In the case of unsatisfactory calibration, customized severity of illness models may be useful as an adjunct for quality control.

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confidence: 73%

Ratios of observed to expected mortality are affected by differences in case mix and quality of care

et al. 2000

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“…the latter to how closely predictions are correlated with actual outcome across the entire range of risk [4]. Good discrimination has been demonstrated for SAPS II in multicenter studies performed in Italy [5], Portugal [6], Austria [7], as well as in the European group of ICUs EURICUS-I [8]. Also, APACHE II has shown good discriminative ability in Portugal [6] and the United Kingdom [9].…”

Section: Validation Of Severity Scoring Systems Saps II and Apache Iimentioning

confidence: 99%

“…Also, APACHE II has shown good discriminative ability in Portugal [6] and the United Kingdom [9]. However, most of these studies [5,6,7,8] report calibration as disappointing.…”

Section: Validation Of Severity Scoring Systems Saps II and Apache Iimentioning

confidence: 99%

Validation of severity scoring systems SAPS II and APACHE II in a single-center population

et al. 2000

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“…Although more recent severity scores versions were developed in the nineties [2][3][4], the APACHE II remains, to date, the most widely used scoring system for ICUs assessment and for clinical trials conducted in the field of critical care medicine. Nevertheless, several studies showed a deterioration of both APACHE II and SAPS II scores performances [5][6][7][8]. The recently published SAPS 3 admission score [9] is a model built to predict hospital mortality from admission data (recorded within ±1 h).…”

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confidence: 99%

SAPS 3 admission score: an external validation in a general intensive care population

et al. 2008

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Objectives: To validate the SAPS 3 admission score in an independent general intensive care case mix and to compare its performances with the APACHE II and the SAPS II scores. Design: Cohort observational study. Setting: A 26-bed general ICU from a Tertiary University Hospital. Patients and participants: Eight hundred and fifty-one consecutive patients admitted to the ICU over an 8-month period. Of these patients, 49 were readmissions, leaving 802 patients for further analysis. Intervention: None. Measurements and results: APACHE II, SAPS II and SAPS 3 variables were prospectively collected; scores and their derived probability of death were calculated according to their original manuscript description. The discriminative power was assessed using the area under the ROC curve (AUROC) and calibration was verified with the Hosmer-Lemeshow goodness-of-fit test. The AUROC of the APACHE II model (AUROC = 0.823) was significantly lower than those of the SAPS II (AUROC = 0.850) and SAPS 3 models (AUROC = 0.854) (P = 0.038). The calibration of the APACHE II model (P = 0.037) and of the SAPS 3 global model (P = 0.035) appeared unsatisfactory. On the contrary, both SAPS II model and SAPS 3 model customised for Central and Western Europe had a good calibration. However, in our study case mix, SAPS II model tended to overestimate the probability of death. Conclusion: In this study, the SAPS 3 admission score and its prediction model customised for Central and Western Europe was more discriminative and better calibrated than APACHE II, but it was not significantly better than the SAPS II.

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The performance of SAPS II in a cohort of patients admitted to 99 Italian ICUs: Results from GiViTI

Cited by 111 publications

References 22 publications

Ratios of observed to expected mortality are affected by differences in case mix and quality of care

Ratios of observed to expected mortality are affected by differences in case mix and quality of care

Validation of severity scoring systems SAPS II and APACHE II in a single-center population

SAPS 3 admission score: an external validation in a general intensive care population

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