Related Experiment Video
Updated: Jun 8, 2026
Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Is the SAPS II score valid in surgical intensive care unit patients?
Yasser Sakr1, Juliana Marques, Stefan Mortsch
1Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University Hospital, Jena, Germany. yasser.sakr@med.uni-jena.de
Aims And Objectives:
We investigated the performance of the simplified acute physiology score II (SAPS II) in a large cohort of surgical intensive care unit (ICU) patients and tested the hypothesis that customization of the score would improve the uniformity of fit in subgroups of surgical ICU patients.
Methods:
Retrospective analysis of prospectively collected data from all 12,938 patients admitted to a postoperative ICU between January 2004 and January 2009. Probabilities of hospital death were calculated for original and customized (C1-SAPS II and C2-SAPS II) scores. A priori subgroups were defined according to age, probability of death according to the SAPS II score, ICU length of stay (LOS), surgical procedures and type of admission.
Results:
The median ICU LOS was 1 (1-3) day. ICU and hospital mortality rates were 5.8% and 10.3%, respectively. Discrimination of the SAPS II was moderate [area under receiver operating characteristic curve (aROC) = 0.76 (0.75-0.78)], but calibration was poor. This model markedly overestimated hospital mortality rates [standardized mortality rate: 0.35 (0.33-0.37)]. First-level customization (C1-SAPS II) did not improve discrimination in the whole cohort or the subgroups, but calibration improved in some subgroups. Second-level customization (C2-SAPS II) improved discrimination in the whole cohort [aROC = 0.82 (0.79-0.85)] and most of the subgroups (aROC range 0.65-86). Calibration in this model (C2-SAPS II) improved in the whole cohort and in subgroups except in patients with ICU LOS 4-14 days and those undergoing neuro- or gastrointestinal surgery.
Conclusions:
In this large cohort of surgical ICU patients, performance of the original SAPS II model was generally poor. Although second-level customization improved discrimination and calibration in the whole cohort and most of the subgroups, it failed to simultaneously improve calibration in the subgroups stratified according to the type of surgery, age or ICU LOS.
Related Concept Videos
01:14SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...