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Erschienen in:
01.04.2009 | Original
Austrian validation and customization of the SAPS 3 Admission Score
Erschienen in: Intensive Care Medicine | Ausgabe 4/2009
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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: Ĥ = 4.50, P = 0.922; Ĉ = 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.