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The ability of the Simplified Acute Physiology Score (SAPS II) to predict outcome in coronary care patients
H P Schuster1, F P Schuster, P Ritschel
1Medizinische Klinik I, Städtisches Krankenhaus Hildesheim, Germany.
Objective:
To evaluate the applicability of the Simplified Acute Physiology Score (SAPS II) for coronary care patients.
Design:
Prospective observational cohort study.
Setting:
Medical ICU of a community teaching hospital.
Patients:
1587 consecutive patients admitted over a period of 18 months.
Measurements And Main Results:
Patients were divided in two groups according to the primary admission diagnosis: general medical intensive care (ICU) patients and intensive coronary care (CCU) patients. Score prediction was tested using criteria suitable to evaluate the discrimination and calibration properties of SAPS II. Mean SAPS II score was 31.6 (+/- 20.1) in ICU and 28.3 (+/- 15.5) in CCU patients (p = 0.06), mean risk of death 0.206 and 0.134 (p = 0.001), and observed hospital mortality 17.8 vs 10.3%. The area under the receiver operating characteristic curve was 0.888 in ICU and 0.908 in CCU patients (p = 0.5). The correlation between predicted and observed hospital mortality was 0.62 (p = 0.001) in ICU and 0.66 (p = 0.001) in CCU patients. The calibration curves did not differ from each other. The probability of death in survivors and nonsurvivors was equally distributed in ICU and CCU patients (p = 0.5).
Conclusion:
We conclude that SAPS II is applicable to CCU patients in our unit.