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01-07-2010 | Original

Validation of four prognostic scores in patients with cancer admitted to Brazilian intensive care units: results from a prospective multicenter study

Authors: Márcio Soares, Ulisses V. A. Silva, José M. M. Teles, Eliézer Silva, Pedro Caruso, Suzana M. A. Lobo, Felipe Dal Pizzol, Luciano P. Azevedo, Frederico B. de Carvalho, Jorge I. F. Salluh

Published in: Intensive Care Medicine | Issue 7/2010

Abstract

Objective

The aim of the present study was to validate the Simplified Acute Physiology Score II (SAPS II) and 3 (SAPS 3), the Mortality Probability Models III (MPM₀-III), and the Cancer Mortality Model (CMM) in patients with cancer admitted to several intensive care units (ICU).

Design

Prospective multicenter cohort study.

Setting

Twenty-eight ICUs in Brazil.

Patients

Seven hundred and seventeen consecutive patients (solid tumors 93%; hematological malignancies 7%) included over a 2-month period.

Interventions

None.

Measurements and main results

Discrimination was assessed by area under receiver operating characteristic (AROC) curves and calibration by Hosmer–Lemeshow goodness-of-fit test. The main reasons for ICU admission were postoperative care (57%), sepsis (15%) and respiratory failure (10%). The ICU and hospital mortality rates were 21 and 30%, respectively. When all 717 patients were evaluated, discrimination was superior for both SAPS II (AROC = 0.84) and SAPS 3 (AROC = 0.84) scores compared to CMM (AROC = 0.79) and MPM₀-III (AROC = 0.71) scores (P < 0.05 in all comparisons). Calibration was better using CMM and the customized equation of SAPS 3 score for South American countries (CSA). MPM₀-III, SAPS II and standard SAPS 3 scores underestimated mortality (standardized mortality ratio, SMR > 1), while CMM tended to overestimation (SMR = 0.48). However, using the SAPS 3 for CSA resulted in more precise estimations of the probability of death [SMR = 1.02 (95% confidence interval = 0.87–1.19)]. Similar results were observed when scheduled surgical patients were excluded.

Conclusions

In this multicenter study, the customized equation of SAPS 3 score for CSA was found to be accurate in predicting outcomes in cancer patients requiring ICU admission.

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Title: Validation of four prognostic scores in patients with cancer admitted to Brazilian intensive care units: results from a prospective multicenter study
Authors: Márcio Soares
Ulisses V. A. Silva
José M. M. Teles
Eliézer Silva
Pedro Caruso
Suzana M. A. Lobo
Felipe Dal Pizzol
Luciano P. Azevedo
Frederico B. de Carvalho
Jorge I. F. Salluh
Publication date: 01-07-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-010-1807-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Validation of four prognostic scores in patients with cancer admitted to Brazilian intensive care units: results from a prospective multicenter study

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and main results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and main results

Conclusions

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