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Intensive Care Med. 2009 Nov;35(11):1916-24. doi: 10.1007/s00134-009-1615-0. Epub 2009 Aug 14.

External validation of the Simplified Acute Physiology Score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units.

Author information

1
Servizio Anestesia e Rianimazione, Ospedale Civile San Martino, Belluno, Italy. danest@libero.it

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-of-fit 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.

PMID:
19685038
DOI:
10.1007/s00134-009-1615-0
[Indexed for MEDLINE]

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