Abstract Objective: To evaluate the SAPS 3 score predictive ability of hospital mortality in a large external validation cohort. Design: Prospective observational study. Setting and patients: A total of 28,357 patients from 147 Italian ICUs joining the Project Margherita national database of the Gruppo italiano per la Valutazione degli interventi in Terapia Intensiva (GiViTI). Interventions: None. Measurement: Evaluation of discrimination through ROC analysis and of overall goodness-offit through the Cox calibration test. Main results: Although discrimination was good, calibration turned out to be poor. The general and the South-Europe Mediterranean countries equations overestimated hospital mortality overall (SMR values 0.73 with 95% CI 0.72–0.75 for both equations) and homogeneously across risk classes. Overprediction was confirmed among important subgroups, with SMR values ranging between 0.47 and 0.82. Conclusions: The result strictly supported by our data is that the SAPS 3 score calibrates inadequately in a large sample of Italian ICU patients and thus should not be used for benchmarking, at least in Italian settings.
External validation of the Simplified Acute Physiology Score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units / D. Poole, C. Rossi, A. Anghileri, M. Giardino, N. Latronico, D. Radrizzani, M. Langer, G. Bertolini. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - 37:11(2009 Aug), pp. 1016-1024.
External validation of the Simplified Acute Physiology Score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units
M. LangerPenultimo
;
2009
Abstract
Abstract Objective: To evaluate the SAPS 3 score predictive ability of hospital mortality in a large external validation cohort. Design: Prospective observational study. Setting and patients: A total of 28,357 patients from 147 Italian ICUs joining the Project Margherita national database of the Gruppo italiano per la Valutazione degli interventi in Terapia Intensiva (GiViTI). Interventions: None. Measurement: Evaluation of discrimination through ROC analysis and of overall goodness-offit through the Cox calibration test. Main results: Although discrimination was good, calibration turned out to be poor. The general and the South-Europe Mediterranean countries equations overestimated hospital mortality overall (SMR values 0.73 with 95% CI 0.72–0.75 for both equations) and homogeneously across risk classes. Overprediction was confirmed among important subgroups, with SMR values ranging between 0.47 and 0.82. Conclusions: The result strictly supported by our data is that the SAPS 3 score calibrates inadequately in a large sample of Italian ICU patients and thus should not be used for benchmarking, at least in Italian settings.Pubblicazioni consigliate
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