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Intensive Care Med. 2009 Apr;35(4):616-22. doi: 10.1007/s00134-008-1286-2. Epub 2008 Oct 10.

Austrian validation and customization of the SAPS 3 Admission Score.

Author information

1
Department of Medical Statistics, Medical University of Vienna, Vienna, Austria.

Abstract

OBJECTIVE:

To test the prognostic performance of the SAPS 3 Admission Score in a regional cohort and to empirically test the need and feasibility of regional customization.

DESIGN:

Prospective multicenter cohort study.

PATIENTS AND SETTING:

Data on a total of 2,060 patients consecutively admitted to 22 intensive care units in Austria from October 2, 2006 to February 28, 2007.

MEASUREMENTS AND RESULTS:

The database includes basic variables, SAPS 3, length-of-stay and outcome data. The original SAPS 3 Admission Score overestimated hospital mortality in Austrian intensive care patients through all strata of the severity-of-illness. This was true for both available equations, the General and the Central and Western Europe equation. For this reason a customized country-specific model was developed, using cross-validation techniques. This model showed excellent calibration and discrimination in the whole cohort (Hosmer-Lemeshow goodness-of-fit: H = 4.50, P = 0.922; C = 5.61, P = 0.847, aROC, 0.82) as well as in the various tested subgroups.

CONCLUSIONS:

The SAPS 3 Admission Score's general equation can be seen as a framework for addressing the problem of outcome prediction in the general population of adult ICU patients. For benchmarking purposes, region-specific or country-specific equations seem to be necessary in order to compare ICUs on a similar level.

PMID:
18846365
DOI:
10.1007/s00134-008-1286-2
[Indexed for MEDLINE]

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