External validation of the simplified acute physiology score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units

Daniele Poole, Carlotta Rossi, Abramo Anghileri, Michele Giardino, Nicola Latronico, Danilo Radrizzani, Martin Langer, Guido Bertolini

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1916-1924
Number of pages9
JournalIntensive Care Medicine
Volume35
Issue number11
DOIs
Publication statusPublished - Nov 2009

Keywords

  • Benchmarking
  • Critical care
  • Hospital mortality
  • Intensive care
  • Outcome assessment
  • Validation study

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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