Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better?
Purpose More recent severity scores should be more reliable than older ones because they account for the improvement in medical care over time. To provide more insight into this issue, we compared the predictive ability of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 (originally develo...
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| Veröffentlicht in: | Intensive care medicine 2012-08, Vol.38 (8), p.1280-1288 |
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| creator | Poole, Daniele Rossi, Carlotta Latronico, Nicola Rossi, Giancarlo Finazzi, Stefano Bertolini, Guido |
| description | Purpose
More recent severity scores should be more reliable than older ones because they account for the improvement in medical care over time. To provide more insight into this issue, we compared the predictive ability of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 (originally developed from data collected in 1991–1992 and 2002, respectively) on a sample of critically ill patients.
Methods
This was a prospective observational study on 3,661 patients from 103 Italian intensive care units. Standardized mortality ratios (SMRs) were calculated. Assessment of calibration across risk classes was performed using the GiViTI calibration belt. Discrimination was evaluated by means of the area under the receiver operating characteristic analysis.
Results
Both scores were shown to discriminate fairly. SAPS 3 largely overpredicted mortality, more than SAPS II (SMR 0.63, 95 % CI 0.60–0.66 vs. 0.87, 95 % CI 0.83–0.91). This result was consistent and statistically significant across all risk classes for SAPS 3. SAPS II did not show relevant deviations from ideal calibration in the first two deciles of risk, whereas in higher-risk classes it overpredicted mortality.
Conclusions
Both scores provided unreliable predictions, but unexpectedly the newer SAPS 3 turned out to overpredict mortality more than the older SAPS II. |
| doi_str_mv | 10.1007/s00134-012-2578-0 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1032891141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A724315246</galeid><sourcerecordid>A724315246</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-181b236d18e1f4afacc35d5a85de1615b0918d4f4ac57fcfc9e315df163943cf3</originalsourceid><addsrcrecordid>eNqNkl2L1DAUhoso7rj6A7yRgCx40zEnX02vZBj8KCworHtdMmkym6VNxqTDMBf-d1M6uiojSC4Sznne8xHeongJeAkYV28TxkBZiYGUhFeyxI-KBTBKSiBUPi4WmDJSMsHIRfEspftMV4LD0-KCEC5ZVdNF8X0dhp2KLgWPNmY8GOPRzerLDWoapHw3vylyHu2i6Zwend-iu5B2blQ9GkLMlxuPE6CQDnc5gIJFgClqppTyqFnfpiVqEvLmgFR_UMc0tRpNfPe8eGJVn8yL031Z3H54_3X9qbz-_LFZr65LzRkeS5CwIVR0IA1YpqzSmvKOK8k7AwL4BtcgO5ZTmldWW10bCryzIGjNqLb0sngz193F8G1v0tgOLmnT98qbsE9tHpfIGoDBf6CkohUVYkJf_4Xeh330eZGJEpLjipEHaqt60zpvwxiVnoq2q4qwPChhIlPlGWprvImqD95Yl8N_8MszfD6dGZw-K4BZoGNIKRrb7qIbVDzmWdvJTe3spja7qZ3c1OKseXVacL8ZTPdL8dM-Gbg6ASpp1duovHbpgRNQCy5l5sjMpZzyWxN__6l_df8By_jcaw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1026850742</pqid></control><display><type>article</type><title>Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better?</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Poole, Daniele ; Rossi, Carlotta ; Latronico, Nicola ; Rossi, Giancarlo ; Finazzi, Stefano ; Bertolini, Guido</creator><creatorcontrib>Poole, Daniele ; Rossi, Carlotta ; Latronico, Nicola ; Rossi, Giancarlo ; Finazzi, Stefano ; Bertolini, Guido ; GiViTI</creatorcontrib><description>Purpose
More recent severity scores should be more reliable than older ones because they account for the improvement in medical care over time. To provide more insight into this issue, we compared the predictive ability of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 (originally developed from data collected in 1991–1992 and 2002, respectively) on a sample of critically ill patients.
Methods
This was a prospective observational study on 3,661 patients from 103 Italian intensive care units. Standardized mortality ratios (SMRs) were calculated. Assessment of calibration across risk classes was performed using the GiViTI calibration belt. Discrimination was evaluated by means of the area under the receiver operating characteristic analysis.
Results
Both scores were shown to discriminate fairly. SAPS 3 largely overpredicted mortality, more than SAPS II (SMR 0.63, 95 % CI 0.60–0.66 vs. 0.87, 95 % CI 0.83–0.91). This result was consistent and statistically significant across all risk classes for SAPS 3. SAPS II did not show relevant deviations from ideal calibration in the first two deciles of risk, whereas in higher-risk classes it overpredicted mortality.
Conclusions
Both scores provided unreliable predictions, but unexpectedly the newer SAPS 3 turned out to overpredict mortality more than the older SAPS II.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-012-2578-0</identifier><identifier>PMID: 22584793</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Analysis ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Calibration ; Critical Care Medicine ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Emergency Medicine ; Health care ; Hospital Mortality ; Hospitals ; Humans ; Intensive ; Intensive care ; Intensive care medicine ; Intensive Care Units ; Italy ; Medical research ; Medical sciences ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Mortality ; Observational studies ; Original ; Outcome Assessment (Health Care) - methods ; Pain Medicine ; Pediatrics ; Physiological aspects ; Physiology ; Pneumology/Respiratory System ; Prospective Studies ; Risk Assessment ; Severity of Illness Index ; Statistical analysis</subject><ispartof>Intensive care medicine, 2012-08, Vol.38 (8), p.1280-1288</ispartof><rights>Copyright jointly held by Springer and ESICM 2012</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2012 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-181b236d18e1f4afacc35d5a85de1615b0918d4f4ac57fcfc9e315df163943cf3</citedby><cites>FETCH-LOGICAL-c540t-181b236d18e1f4afacc35d5a85de1615b0918d4f4ac57fcfc9e315df163943cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-012-2578-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-012-2578-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26196588$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22584793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Poole, Daniele</creatorcontrib><creatorcontrib>Rossi, Carlotta</creatorcontrib><creatorcontrib>Latronico, Nicola</creatorcontrib><creatorcontrib>Rossi, Giancarlo</creatorcontrib><creatorcontrib>Finazzi, Stefano</creatorcontrib><creatorcontrib>Bertolini, Guido</creatorcontrib><creatorcontrib>GiViTI</creatorcontrib><title>Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better?</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose
More recent severity scores should be more reliable than older ones because they account for the improvement in medical care over time. To provide more insight into this issue, we compared the predictive ability of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 (originally developed from data collected in 1991–1992 and 2002, respectively) on a sample of critically ill patients.
Methods
This was a prospective observational study on 3,661 patients from 103 Italian intensive care units. Standardized mortality ratios (SMRs) were calculated. Assessment of calibration across risk classes was performed using the GiViTI calibration belt. Discrimination was evaluated by means of the area under the receiver operating characteristic analysis.
Results
Both scores were shown to discriminate fairly. SAPS 3 largely overpredicted mortality, more than SAPS II (SMR 0.63, 95 % CI 0.60–0.66 vs. 0.87, 95 % CI 0.83–0.91). This result was consistent and statistically significant across all risk classes for SAPS 3. SAPS II did not show relevant deviations from ideal calibration in the first two deciles of risk, whereas in higher-risk classes it overpredicted mortality.
Conclusions
Both scores provided unreliable predictions, but unexpectedly the newer SAPS 3 turned out to overpredict mortality more than the older SAPS II.</description><subject>Analysis</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesiology</subject><subject>Biological and medical sciences</subject><subject>Calibration</subject><subject>Critical Care Medicine</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency Medicine</subject><subject>Health care</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units</subject><subject>Italy</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Original</subject><subject>Outcome Assessment (Health Care) - methods</subject><subject>Pain Medicine</subject><subject>Pediatrics</subject><subject>Physiological aspects</subject><subject>Physiology</subject><subject>Pneumology/Respiratory System</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Statistical analysis</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkl2L1DAUhoso7rj6A7yRgCx40zEnX02vZBj8KCworHtdMmkym6VNxqTDMBf-d1M6uiojSC4Sznne8xHeongJeAkYV28TxkBZiYGUhFeyxI-KBTBKSiBUPi4WmDJSMsHIRfEspftMV4LD0-KCEC5ZVdNF8X0dhp2KLgWPNmY8GOPRzerLDWoapHw3vylyHu2i6Zwend-iu5B2blQ9GkLMlxuPE6CQDnc5gIJFgClqppTyqFnfpiVqEvLmgFR_UMc0tRpNfPe8eGJVn8yL031Z3H54_3X9qbz-_LFZr65LzRkeS5CwIVR0IA1YpqzSmvKOK8k7AwL4BtcgO5ZTmldWW10bCryzIGjNqLb0sngz193F8G1v0tgOLmnT98qbsE9tHpfIGoDBf6CkohUVYkJf_4Xeh330eZGJEpLjipEHaqt60zpvwxiVnoq2q4qwPChhIlPlGWprvImqD95Yl8N_8MszfD6dGZw-K4BZoGNIKRrb7qIbVDzmWdvJTe3spja7qZ3c1OKseXVacL8ZTPdL8dM-Gbg6ASpp1duovHbpgRNQCy5l5sjMpZzyWxN__6l_df8By_jcaw</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Poole, Daniele</creator><creator>Rossi, Carlotta</creator><creator>Latronico, Nicola</creator><creator>Rossi, Giancarlo</creator><creator>Finazzi, Stefano</creator><creator>Bertolini, Guido</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>20120801</creationdate><title>Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better?</title><author>Poole, Daniele ; Rossi, Carlotta ; Latronico, Nicola ; Rossi, Giancarlo ; Finazzi, Stefano ; Bertolini, Guido</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-181b236d18e1f4afacc35d5a85de1615b0918d4f4ac57fcfc9e315df163943cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Analysis</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Calibration</topic><topic>Critical Care Medicine</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency Medicine</topic><topic>Health care</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Italy</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Observational studies</topic><topic>Original</topic><topic>Outcome Assessment (Health Care) - methods</topic><topic>Pain Medicine</topic><topic>Pediatrics</topic><topic>Physiological aspects</topic><topic>Physiology</topic><topic>Pneumology/Respiratory System</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poole, Daniele</creatorcontrib><creatorcontrib>Rossi, Carlotta</creatorcontrib><creatorcontrib>Latronico, Nicola</creatorcontrib><creatorcontrib>Rossi, Giancarlo</creatorcontrib><creatorcontrib>Finazzi, Stefano</creatorcontrib><creatorcontrib>Bertolini, Guido</creatorcontrib><creatorcontrib>GiViTI</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poole, Daniele</au><au>Rossi, Carlotta</au><au>Latronico, Nicola</au><au>Rossi, Giancarlo</au><au>Finazzi, Stefano</au><au>Bertolini, Guido</au><aucorp>GiViTI</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better?</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>38</volume><issue>8</issue><spage>1280</spage><epage>1288</epage><pages>1280-1288</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Purpose
More recent severity scores should be more reliable than older ones because they account for the improvement in medical care over time. To provide more insight into this issue, we compared the predictive ability of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 (originally developed from data collected in 1991–1992 and 2002, respectively) on a sample of critically ill patients.
Methods
This was a prospective observational study on 3,661 patients from 103 Italian intensive care units. Standardized mortality ratios (SMRs) were calculated. Assessment of calibration across risk classes was performed using the GiViTI calibration belt. Discrimination was evaluated by means of the area under the receiver operating characteristic analysis.
Results
Both scores were shown to discriminate fairly. SAPS 3 largely overpredicted mortality, more than SAPS II (SMR 0.63, 95 % CI 0.60–0.66 vs. 0.87, 95 % CI 0.83–0.91). This result was consistent and statistically significant across all risk classes for SAPS 3. SAPS II did not show relevant deviations from ideal calibration in the first two deciles of risk, whereas in higher-risk classes it overpredicted mortality.
Conclusions
Both scores provided unreliable predictions, but unexpectedly the newer SAPS 3 turned out to overpredict mortality more than the older SAPS II.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22584793</pmid><doi>10.1007/s00134-012-2578-0</doi><tpages>9</tpages></addata></record> |
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| ispartof | Intensive care medicine, 2012-08, Vol.38 (8), p.1280-1288 |
| issn | 0342-4642 1432-1238 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Analysis Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesiology Biological and medical sciences Calibration Critical Care Medicine Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Emergency Medicine Health care Hospital Mortality Hospitals Humans Intensive Intensive care Intensive care medicine Intensive Care Units Italy Medical research Medical sciences Medicine Medicine & Public Health Medicine, Experimental Mortality Observational studies Original Outcome Assessment (Health Care) - methods Pain Medicine Pediatrics Physiological aspects Physiology Pneumology/Respiratory System Prospective Studies Risk Assessment Severity of Illness Index Statistical analysis |
| title | Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better? |
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