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.
|Titolo:||External validation of the Simplified Acute Physiology Score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units|
LANGER, MARTIN (Penultimo)
|Parole Chiave:||Benchmarking; Critical care; Hospital mortality; Intensive care; Outcome assessment; Validation study|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
|Data di pubblicazione:||ago-2009|
|Digital Object Identifier (DOI):||10.1007/s00134-009-1615-0|
|Appare nelle tipologie:||01 - Articolo su periodico|