Auriant I, Vinatier I, Thaler F, Tourneur M, Loirat P
Service de Réanimation, Hôpital Foch, Suresnes, France.
Crit Care Med. 1998 Aug;26(8):1368-71. doi: 10.1097/00003246-199808000-00023.
To assess the efficacy of the Simplified Acute Physiology Score (SAPS II) in intermediate care units. A number of patients hospitalized in the intensive care unit (ICU) could be hospitalized in alternative structures, intermediate care units, which are equipped to handle their monitoring needs and able to provide adequate treatment at a lower cost. Characterization of the patients relies on the assessment of their severity of illness by severity scores. The efficiency of severity scores has been established in ICU patients, but not in the setting of intermediate care units.
Prospective study.
Intermediate care unit of a multidisciplinary hospital.
Four hundred thirty-three patients admitted to the intermediate care unit.
None.
Of 561 consecutive patients admitted to the intermediate care unit during a 12-mo period, 433 patients could be included in the analysis. Patients were admitted from the emergency ward (60.9%). Of the study patients, 60.9% were admitted from the emergency ward for mostly (96%) medical reasons. Average length of stay was 3.1 +/- 2.3 (SD) days. Death rate in the intermediate care unit was 2.7% (n = 11). Average SAPS II was 22.3 +/- 12.0 (range 6 to 73). Hospital death rate was 8.1%, whereas the expected mortality rate derived from SAPS II was 8.7%. To assess the performance of the system, a formal goodness-of-fit test was performed to evaluate calibration. Calibration was accurate using the C coefficient of Hosmer-Lemeshow statistics (C = 2.4; p> 0.5). The discriminant power of SAPS II, measured by the area under the receiver operating characteristic curve was excellent (0.85 +/- 0.04).
The SAPS II assessment of severity of illness in patients admitted to an intermediate care unit is reliable. These results will need to be confirmed, using different patient samplings from intermediate care units.
评估简化急性生理学评分（SAPS II）在中间护理单元中的有效性。许多入住重症监护病房（ICU）的患者可以在替代结构即中间护理单元中住院，这些单元配备了满足其监测需求的设备，并能够以较低成本提供充分治疗。对患者的特征描述依赖于通过严重程度评分来评估其疾病严重程度。严重程度评分在ICU患者中的有效性已得到证实，但在中间护理单元环境中尚未得到证实。
前瞻性研究。
一家多学科医院的中间护理单元。
433名入住中间护理单元的患者。
无。
在12个月期间连续入住中间护理单元的561名患者中，433名患者可纳入分析。患者从急诊病房收治（60.9%）。在研究患者中，60.9%从急诊病房收治，主要（96%）是由于医疗原因。平均住院时间为3.1±2.3（标准差）天。中间护理单元的死亡率为2.7%（n = 11）。平均SAPS II为22.3±12.0（范围6至73）。医院死亡率为8.1%，而根据SAPS II得出的预期死亡率为8.7%。为评估该系统的性能，进行了正式的拟合优度检验以评估校准情况。使用Hosmer-Lemeshow统计量的C系数进行校准时结果准确（C = 2.4；p>0.5）。通过受试者操作特征曲线下面积测量的SAPS II的判别能力极佳（0.85±0.04）。
SAPS II对入住中间护理单元患者疾病严重程度的评估是可靠的。这些结果需要使用来自不同中间护理单元的患者样本进行确认。
