External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2017 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/31560 |
Resumo: | D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Rio de Janeiro, RJ, Brasil. |
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Moralez, Giulliana MartinesRabello, Ligia Sarmet Cunha FarahLisboa, Thiago CostaLima, Mariza da Fonte AndradeHatum, Rodrigo MarquesMarco, Fernando Vinicius Cesar deAlves, AlessandraPinto, Jorge Eduardo da Silva SoaresAraújo, Hélia Beatriz Nunes deRamos, Grazielle VianaSilva, Aline ReisFernandes, Guilherme CôrtesFaria, Guilherme Brenande AlvesMendes, Ciro LeiteRamos Filho, Roberto ÁlvaroSouza, Valdênia Pereira deBrasil, Pedro Emmanuel Alvarenga Americano doBozza, Fernando AugustoSalluh, Jorge Ibrain FigueiraSoares, Marcio2019-02-12T11:51:38Z2019-02-12T11:51:38Z2017MORALES, Giulliana Martines et al. External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs. Annals of Intensive Care, v. 7, n. 53, p. 1-8, 2017.2110-5820https://www.arca.fiocruz.br/handle/icict/3156010.1186/s13613-017-0276-32110-5820engBMCExternal validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleD’Or Institute for Research and Education. Graduate Program in Translational Medicine. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. 2 PPG Internal Medicine. Rio de Janeiro, RJ, Brazil / Hospital Copa D’Or. Rio de Janeiro, RJ, Brazil.Santa Casa de Misericórdia de Porto Alegre. Complexo Hospitalar. Porto Alegre, RS, Brazil.Hospital Esperança Recife. Recife, PE, Brazil.Hospital Total Cor. Rio de Janeiro, RJ, Brazil.Hospital viValle. São José dos Campos, SP, Brazil.Hospital Rios D’Or. Rio de Janeiro, RJ, Brazil.Hospital Norte D’Or. Rio de Janeiro, RJ, Brazil.Hospital do Coração do Brasil. Brasília, DF, Brazil.D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil.Santa Casa de Misericórdia de Juiz de Fora. Juiz de Fora, MG, Brazil.Hospital Oeste D’Or. Rio de Janeiro, RJ, Brazil.Hospital Universitário Lauro Wanderley. João Pessoa, PB, Brazil.Hospital São Luiz. Unidade Jabaquara. São Paulo, SP, Brazil.Complexo Hospitalar de Niterói. Niterói, RJ, Brazil.D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. PPG Internal Medicine. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Department of Critical Care and Graduate Program in Translational Medicine. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. PPG Internal Medicine. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Department of Critical Care and Graduate Program in Translational Medicine. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil.Background: The performance of severity-of-illness scores varies in diferent scenarios and must be validated prior of being used in a specifc settings and geographic regions. Moreover, models’ calibration may deteriorate overtime and performance of such instruments should be reassessed regularly. Therefore, we aimed at to validate the SAPS 3 in a large contemporary cohort of patients admitted to Brazilian ICUs. In addition, we also compared the performance of the SAPS 3 with the MPM0-III. Methods: This is a retrospective cohort study in which 48,816 (medical admissions = 67.9%) adult patients are admitted to 72 Brazilian ICUs during 2013. We evaluated models’ discrimination using the area under the receiver operating characteristic curve (AUROC). We applied the calibration belt to evaluate the agreement between observed and expected mortality rates (calibration). Results: Mean SAPS 3 score was 44.3 ± 15.4 points. ICU and hospital mortality rates were 11.0 and 16.5%. We estimated predicted mortality using both standard (SE) and Central and South American (CSA) customized equations. Predicted mortality rates were 16.4 ± 19.3% (SAPS 3-SE), 21.7 ± 23.2% (SAPS 3-CSA) and 14.3 ± 14.0% (MPM0-III). Standardized mortality ratios (SMR) obtained for each model were: 1.00 (95% CI, 0.98–0.102) for the SAPS 3-SE, 0.75 (0.74–0.77) for the SAPS 3-CSA and 1.15 (1.13–1.18) for the MPM0-III. Discrimination was better for SAPS 3 models (AUROC = 0.85) than for MPM0-III (AUROC = 0.80) (p < 0.001). We applied the calibration belt to evaluate the agreement between observed and expected mortality rates (calibration): the SAPS 3-CSA overestimated mortality throughout all risk classes while the MPM0-III underestimated it uniformly. The SAPS 3-SE did not show relevant deviations from ideal calibration. Conclusions: In a large contemporary database, the SAPS 3-SE was accurate in predicting outcomes, supporting itsuse for performance evaluation and benchmarking in Brazilian ICUs.Severity-of-illness scoresValidationIntensive care unitsOutcomesStandardized mortality rateinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/31560/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALve_Moralez_Giuliana_etal_INI_2017.pdfve_Moralez_Giuliana_etal_INI_2017.pdfapplication/pdf1319856https://www.arca.fiocruz.br/bitstream/icict/31560/2/ve_Moralez_Giuliana_etal_INI_2017.pdf7c06b9b328ed3abb77d3407cf0c99bdbMD52TEXTve_Moralez_Giuliana_etal_INI_2017.pdf.txtve_Moralez_Giuliana_etal_INI_2017.pdf.txtExtracted 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| dc.title.pt_BR.fl_str_mv |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| title |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| spellingShingle |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs Moralez, Giulliana Martines Severity-of-illness scores Validation Intensive care units Outcomes Standardized mortality rate |
| title_short |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| title_full |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| title_fullStr |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| title_full_unstemmed |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| title_sort |
External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs |
| author |
Moralez, Giulliana Martines |
| author_facet |
Moralez, Giulliana Martines Rabello, Ligia Sarmet Cunha Farah Lisboa, Thiago Costa Lima, Mariza da Fonte Andrade Hatum, Rodrigo Marques Marco, Fernando Vinicius Cesar de Alves, Alessandra Pinto, Jorge Eduardo da Silva Soares Araújo, Hélia Beatriz Nunes de Ramos, Grazielle Viana Silva, Aline Reis Fernandes, Guilherme Côrtes Faria, Guilherme Brenande Alves Mendes, Ciro Leite Ramos Filho, Roberto Álvaro Souza, Valdênia Pereira de Brasil, Pedro Emmanuel Alvarenga Americano do Bozza, Fernando Augusto Salluh, Jorge Ibrain Figueira Soares, Marcio |
| author_role |
author |
| author2 |
Rabello, Ligia Sarmet Cunha Farah Lisboa, Thiago Costa Lima, Mariza da Fonte Andrade Hatum, Rodrigo Marques Marco, Fernando Vinicius Cesar de Alves, Alessandra Pinto, Jorge Eduardo da Silva Soares Araújo, Hélia Beatriz Nunes de Ramos, Grazielle Viana Silva, Aline Reis Fernandes, Guilherme Côrtes Faria, Guilherme Brenande Alves Mendes, Ciro Leite Ramos Filho, Roberto Álvaro Souza, Valdênia Pereira de Brasil, Pedro Emmanuel Alvarenga Americano do Bozza, Fernando Augusto Salluh, Jorge Ibrain Figueira Soares, Marcio |
| author2_role |
author author author author author author author author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Moralez, Giulliana Martines Rabello, Ligia Sarmet Cunha Farah Lisboa, Thiago Costa Lima, Mariza da Fonte Andrade Hatum, Rodrigo Marques Marco, Fernando Vinicius Cesar de Alves, Alessandra Pinto, Jorge Eduardo da Silva Soares Araújo, Hélia Beatriz Nunes de Ramos, Grazielle Viana Silva, Aline Reis Fernandes, Guilherme Côrtes Faria, Guilherme Brenande Alves Mendes, Ciro Leite Ramos Filho, Roberto Álvaro Souza, Valdênia Pereira de Brasil, Pedro Emmanuel Alvarenga Americano do Bozza, Fernando Augusto Salluh, Jorge Ibrain Figueira Soares, Marcio |
| dc.subject.en.pt_BR.fl_str_mv |
Severity-of-illness scores Validation Intensive care units Outcomes Standardized mortality rate |
| topic |
Severity-of-illness scores Validation Intensive care units Outcomes Standardized mortality rate |
| description |
D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Rio de Janeiro, RJ, Brasil. |
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2017 |
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2017 |
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2019-02-12T11:51:38Z |
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2019-02-12T11:51:38Z |
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MORALES, Giulliana Martines et al. External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs. Annals of Intensive Care, v. 7, n. 53, p. 1-8, 2017. |
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https://www.arca.fiocruz.br/handle/icict/31560 |
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2110-5820 |
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10.1186/s13613-017-0276-3 |
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2110-5820 |
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MORALES, Giulliana Martines et al. External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs. Annals of Intensive Care, v. 7, n. 53, p. 1-8, 2017. 2110-5820 10.1186/s13613-017-0276-3 |
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