Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yonsei Med J. 2011 Jan;52(1):59-64. doi: 10.3349/ymj.2011.52.1.59.
The Simplified Acute Physiology Score (SAPS) 3 was recently proposed to reflect contemporary changes in intensive care practices. SAPS 3 features customized equations for the prediction of mortality in different geographic regions. However, the usefulness of SAPS 3 and its customized equation (Australasia SAPS 3) have never been externally validated in Korea. This study was designed to validate SAPS 3 and Australasia SAPS 3 for mortality prediction in Korea.
A retrospective analysis of the prospective intensive care unit (ICU) registry was conducted in the medical ICU of Samsung Medical Center. Calibration and discrimination were determined by the Hosmer-Lemeshow test and area under the receiver operating characteristic (aROC) curve from 633 patients.
The mortalities (%) predicted by SAPS 3, Australasia SAPS 3, and SAPS II were 42 ± 28, 39 ± 27 and 37 ± 31, respectively. The calibration of SAPS II was poor (p = 0.003). SAPS 3 and Australasia SAPS 3 were appropriate (p > 0.05). The discriminative power of all models yielded aROC values less than 0.8.
In Korea, mortality rates predicted using general SAPS 3 and Australasia SAPS 3 exhibited good calibration and modest discrimination. However, Australasia SAPS 3 did not improve the mortality prediction. To better predict mortality in Korean ICUs, a new equation may be needed specifically for Korea.
简化急性生理学评分（SAPS）3 最近被提出，以反映重症监护实践的当代变化。SAPS 3 具有针对不同地理区域死亡率预测的定制方程。然而，SAPS 3 及其定制方程（澳大拉西亚 SAPS 3）在韩国从未经过外部验证。本研究旨在验证 SAPS 3 和澳大拉西亚 SAPS 3 在韩国的死亡率预测。
对三星医疗中心内科重症监护病房的前瞻性重症监护病房（ICU）登记进行回顾性分析。通过 Hosmer-Lemeshow 检验和受试者工作特征曲线下面积（aROC）曲线从 633 例患者中确定校准和判别能力。
SAPS 3、澳大拉西亚 SAPS 3 和 SAPS II 预测的死亡率（%）分别为 42±28、39±27 和 37±31。SAPS II 的校准效果不佳（p=0.003）。SAPS 3 和澳大拉西亚 SAPS 3 是合适的（p>0.05）。所有模型的判别能力产生的 aROC 值均小于 0.8。
在韩国，使用一般 SAPS 3 和澳大拉西亚 SAPS 3 预测的死亡率表现出良好的校准和适度的判别能力。然而，澳大拉西亚 SAPS 3 并没有提高死亡率预测。为了更好地预测韩国 ICU 的死亡率，可能需要为韩国专门开发一个新的方程。
