Viabilidade da transição do APACHE II para o SAPS III como modelo prognóstico em uma unidade de terapia intensiva geral no Brasil. Um estudo retrospectivo

Translated title of the contribution: Feasibility of transitioning from APACHE II to SAPS III as prognostic model in a Brazilian general intensive care unit. A retrospective study

Ary Serpa Neto, Murillo Santucci Cesar de Assunção, Andréia Pardini, EliÉzer Silva

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

Abstract

CONTEXT AND OBJECTIVE: Prognostic models reflect the population characteristics of the countries from which they originate. Predictive models should be customized to fit the general population where they will be used. The aim here was to perform external validation on two predictive models and compare their performance in a mixed population of critically ill patients in Brazil. DESIGN AND SETTING: Retrospective study in a Brazilian general intensive care unit (ICU). METHODS: This was a retrospective review of all patients admitted to a 41-bed mixed ICU from August 2011 to September 2012. Calibration (assessed using the Hosmer-Lemeshow goodness-of-fit test) and discrimination (assessed using area under the curve) of APACHE II and SAPS III were compared. The standardized mortality ratio (SMR) was calculated by dividing the number of observed deaths by the number of expected deaths. RESULTS: A total of 3, 333 ICU patients were enrolled. The Hosmer-Lemeshow goodness-of-fit test showed good calibration for all models in relation to hospital mortality. For in-hospital mortality there was a worse fit for APACHE II in clinical patients. Discrimination was better for SAPS III for in-ICU and in-hospital mortality (P = 0.042). The SMRs for the whole population were 0.27 (confidence interval [CI]: 0.23–0.33) for APACHE II and 0.28 (CI: 0.22–0.36) for SAPS III. CONCLUSIONS: In this group of critically ill patients, SAPS III was a better prognostic score, with higher discrimination and calibration power.

Translated title of the contributionFeasibility of transitioning from APACHE II to SAPS III as prognostic model in a Brazilian general intensive care unit. A retrospective study
Original languagePortuguese
Pages (from-to)199-205
Number of pages7
JournalSao Paulo Medical Journal
Volume133
Issue number3
DOIs
Publication statusPublished - May 2015
Externally publishedYes

Keywords

  • APACHE
  • Intensive care
  • Intensive care units
  • Mortality
  • Prognosis

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