Márcio Soares1, Jorge I F Salluh. 1. Instituto Nacional de Câncer - INCA, Centro de Tratamento Intensivo, 10o Andar, Pça. Cruz Vermelha, 23, 20230-130, Rio de Janeiro, RJ, Brazil. marciosoaresms@yahoo.com.br
Abstract
OBJECTIVES: To validate the SAPS 3 admission prognostic model in patients with cancer admitted to the intensive care unit (ICU). DESIGN: Cohort study. SETTING: Ten-bed medical-surgical oncologic ICU. PATIENTS AND PARTICIPANTS: Nine hundred and fifty-two consecutive patients admitted over a 3-year period. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Data were prospectively collected at admission of ICU. SAPS II and SAPS 3 scores with respective estimated mortality rates were calculated. Discrimination was assessed by area under receiver operating characteristic (AUROC) curves and calibration by Hosmer-Lemeshow goodness-of-fit test. The mean age was 58.3+/-23.1 years; there were 471 (49%) scheduled surgical, 348 (37%) medical and 133 (14%) emergency surgical patients. ICU and hospital mortality rates were 24.6% and 33.5%, respectively. The mean SAPS 3 and SAPS II scores were 52.3+/-18.5 points and 35.3+/-20.7 points, respectively. All prognostic models showed excellent discrimination (AUROC>or=0.8). The calibration of SAPS II was poor (p<0.001). However, the calibration of standard SAPS 3 and its customized equation for Central and South American (CSA) countries were appropriate (p>0.05). SAPS II and standard SAPS 3 prognostic models tended somewhat to underestimate the observed mortality (SMR>1). However, when the customized equation was used, the estimated mortality was closer to the observed mortality [SMR=0.95 (95% CI=0.84-1.07)]. Similar results were observed when scheduled surgical patients were excluded. CONCLUSIONS: The SAPS 3 admission prognostic model at ICU admission, in particular its customized equation for CSA, was accurate in our cohort of critically ill patients with cancer.
OBJECTIVES: To validate the SAPS 3 admission prognostic model in patients with cancer admitted to the intensive care unit (ICU). DESIGN: Cohort study. SETTING: Ten-bed medical-surgical oncologic ICU. PATIENTS AND PARTICIPANTS: Nine hundred and fifty-two consecutive patients admitted over a 3-year period. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Data were prospectively collected at admission of ICU. SAPS II and SAPS 3 scores with respective estimated mortality rates were calculated. Discrimination was assessed by area under receiver operating characteristic (AUROC) curves and calibration by Hosmer-Lemeshow goodness-of-fit test. The mean age was 58.3+/-23.1 years; there were 471 (49%) scheduled surgical, 348 (37%) medical and 133 (14%) emergency surgical patients. ICU and hospital mortality rates were 24.6% and 33.5%, respectively. The mean SAPS 3 and SAPS II scores were 52.3+/-18.5 points and 35.3+/-20.7 points, respectively. All prognostic models showed excellent discrimination (AUROC>or=0.8). The calibration of SAPS II was poor (p<0.001). However, the calibration of standard SAPS 3 and its customized equation for Central and South American (CSA) countries were appropriate (p>0.05). SAPS II and standard SAPS 3 prognostic models tended somewhat to underestimate the observed mortality (SMR>1). However, when the customized equation was used, the estimated mortality was closer to the observed mortality [SMR=0.95 (95% CI=0.84-1.07)]. Similar results were observed when scheduled surgical patients were excluded. CONCLUSIONS: The SAPS 3 admission prognostic model at ICU admission, in particular its customized equation for CSA, was accurate in our cohort of critically illpatients with cancer.
Authors: J L Vincent; R Moreno; J Takala; S Willatts; A De Mendonça; H Bruining; C K Reinhart; P M Suter; L G Thijs Journal: Intensive Care Med Date: 1996-07 Impact factor: 17.440
Authors: Peter Schellongowski; Michael Benesch; Thomas Lang; Friederike Traunmüller; Christian Zauner; Klaus Laczika; Gottfried J Locker; Michael Frass; Thomas Staudinger Journal: Intensive Care Med Date: 2003-11-04 Impact factor: 17.440
Authors: Philipp G H Metnitz; Rui P Moreno; Eduardo Almeida; Barbara Jordan; Peter Bauer; Ricardo Abizanda Campos; Gaetano Iapichino; David Edbrooke; Maurizia Capuzzo; Jean-Roger Le Gall Journal: Intensive Care Med Date: 2005-08-17 Impact factor: 17.440
Authors: Márcio Soares; Ulisses V A Silva; José M M Teles; Eliézer Silva; Pedro Caruso; Suzana M A Lobo; Felipe Dal Pizzol; Luciano P Azevedo; Frederico B de Carvalho; Jorge I F Salluh Journal: Intensive Care Med Date: 2010-03-11 Impact factor: 17.440
Authors: Michael von Bergwelt-Baildon; Michael J Hallek; Alexander A Shimabukuro-Vornhagen; Matthias Kochanek Journal: BMC Cancer Date: 2010-11-08 Impact factor: 4.430
Authors: Barbara Metnitz; Eva Schaden; Rui Moreno; Jean-Roger Le Gall; Peter Bauer; Philipp G H Metnitz Journal: Intensive Care Med Date: 2008-10-10 Impact factor: 17.440
Authors: Vanessa M de Oliveira; Janete S Brauner; Edison Rodrigues Filho; Ruth G A Susin; Viviane Draghetti; Simone T Bolzan; Silvia R R Vieira Journal: Clinics (Sao Paulo) Date: 2013 Impact factor: 2.365