Izvorni znanstveni članak
Prognostic performance of the Simplified Acute Physiology Score II in major Croatian hospitals: a prospective multicenter study
Kristian Deša
orcid.org/0000-0002-2068-7984
; Department of Anesthesiology and Intensive Care Medicine, Rijeka University Hospital, Rijeka, Croatia
Mladen Perić
; Department of Anesthesiology and Intensive Care Medicine, “Sestre milosrdnice” University Hospital, Zagreb, Croatia
Ino Husedžinović
; Department of Anesthesiology and Intensive Care Medicine, Dubrava University Hospital, Zagreb, Croatia
Alan Šustić
; Department of Anesthesiology and Intensive Care Medicine, Rijeka University Hospital, Rijeka, Croatia
Anđelko Korušić
; Department of Anesthesiology and Intensive Care Medicine, Dubrava University Hospital, Zagreb, Croatia
Vjekoslav Karadža
; Department of Anesthesiology and Intensive Care Medicine Jordanovac University Hospital for Lung Diseases, Zagreb, Croatia
Dražen Matleković
; Department of Anesthesiology and Intensive Care Medicine, Merkur University Hospital, Zagreb, Croatia
Branka Prstec-Veronek
; Department of Anesthesiology and Intensive Care Medicine, Varaždin General Hospital, Varaždin, Croatia
Marta Žuvić-Butorac
; Faculty of Engineering, University of Rijeka, Rijeka, Croatia
Jadranko Sokolić
; Department of Anesthesiology and Intensive Care Medicine, Rijeka University Hospital, Rijeka, Croatia
Mladen Širanović
; Department of Anesthesiology and Intensive Care Medicine, “Sestre milosrdnice” University Hospital, Zagreb, Croatia
Danica Bošnjak
; Department of Anesthesiology and Intensive Care Medicine, Dubrava University Hospital, Zagreb, Croatia
Jasna Špiček-Macan
; Department of Anesthesiology and Intensive Care Medicine Jordanovac University Hospital for Lung Diseases, Zagreb, Croatia
Denis Guštin
; Department of Anesthesiology and Intensive Care Medicine, Merkur University Hospital, Zagreb, Croatia
Draženka Ožeg-Jakopović
; Department of Anesthesiology and Intensive Care Medicine, Varaždin General Hospital, Varaždin, Croatia
Sažetak
Aim To perform an external validation of the original Simplified
Acute Physiology Score II (SAPS II) system and to assess
its performance in a selected group of patients in major
Croatian hospitals.
Methods A prospective, multicenter study was conducted
in five university hospitals and one general hospital during
a six-month period between November 1, 2007 and May 1,
2008. Standardized hospital mortality ratio (SMR) was calculated
from the mean predicted mortality of all the 2756
patients and the actual mortality for the same group of patients.
The validation of SAPS II was made using the area
under receiver operating characteristic curve (AUC), 2 × 2
classification tables, and Hosmer-Lemeshow tests.
Results The predicted mortality was as low as 14.6% due
to a small proportion of medical patients and the SMR being
0.89 (95% confidence interval [CI], 0.78-0.98). The SAPS
II system demonstrated a good discriminatory power as
measured by the AUC (0.85; standard error [SE] = 0.012;
95% CI = 0.840-0.866; P < 0.001). This system significantly
overestimated the actual mortality (Hosmer-Lemeshow
goodness-of-fit H statistic: χ2 = 584.4; P < 0.001 and C statistics:
χ2
8 = 313.0; P < 0.001) in the group of patients included
in the study.
Conclusion The SAPS II had a good discrimination, but it
significantly overestimated the observed mortality in comparison
with the predicted mortality in this group of patients
in Croatia. Therefore, caution is required when an
evaluation is performed at the individual level.
Ključne riječi
Hrčak ID:
94938
URI
Datum izdavanja:
15.10.2012.
Posjeta: 1.986 *