A NEW SIMPLIFIED ACUTE PHYSIOLOGY SCORE (SAPS-II) BASED ON A EUROPEAN NORTH-AMERICAN MULTICENTER STUDY
A NEW SIMPLIFIED ACUTE PHYSIOLOGY SCORE (SAPS-II) BASED ON A EUROPEAN NORTH-AMERICAN MULTICENTER STUDY
复制标题
DOI：
10.1001/jama.270.24.2957
复制
发表时间：
1993-12-22
影响因子：
120.7
通讯作者：
SAULNIER, F
中科院分区：
文献类型：
--
作者：
LEGALL, JR;LEMESHOW, S;SAULNIER, F
客观。-为了开发和验证一个新的简化急性生理评分，SAPS II，从一个大样本的外科和内科病人，并提供一种方法来转换得分的概率医院死亡率。设计和设置。SAPS II和医院死亡率的概率是使用来自12个国家的137个成人内科和/或外科重症监护室的连续入院数据开发和验证的。13152例患者被随机分为开发（65%）和验证（35%）样本。年龄小于18岁的患者、烧伤患者、冠心病护理患者和心脏手术患者被排除在外。出院时的生命状态。结果。SAPS II仅包括17个变量：12个生理学变量、年龄、入院类型（计划手术、计划外手术或内科）和3个基础疾病变量（获得性免疫缺陷综合征、转移性癌症和恶性血液病）。拟合优度检验表明，该模型在发育样本中表现良好，在独立的患者样本中验证良好（在发育和验证样本中分别为P= 0.883和P= 0.104）。受试者工作特征曲线下面积在开发样品中为0.88，在验证样品中为0.86。SAPS II基于大量的国际患者样本，提供了死亡风险的估计，而无需指定初步诊断。这是未来评估重症监护病房效率的起点。
Objective.-To develop and validate a new Simplified Acute Physiology Score, the SAPS II, from a large sample of surgical and medical patients, and to provide a method to convert the score to a probability of hospital mortality.Design and Setting.-The SAPS II and the probability of hospital mortality were developed and validated using data from consecutive admissions to 137 adult medical and/or surgical intensive care units in 12 countries.Patients.-The 13152 patients were randomly divided into developmental (65%) and validation (35%) samples. Patients younger than 18 years, burn patients, coronary care patients, and cardiac surgery patients were excluded.Outcome Measure.-Vital status at hospital discharge.Results.-The SAPS II includes only 17 variables: 12 physiology variables, age, type of admission (scheduled surgical, unscheduled surgical, or medical), and three underlying disease variables (acquired immunodeficiency syndrome, metastatic cancer, and hematologic malignancy). Goodness-of-fit tests indicated that the model performed well in the developmental sample and validated well in an independent sample of patients (P=.883 and P=.104 in the developmental and validation samples, respectively). The area under the receiver operating characteristic curve was 0.88 in the developmental sample and 0.86 in the validation sample.Conclusion.-The SAPS II, based on a large international sample of patients, provides an estimate of the risk of death without having to specify a primary diagnosis. This is a starting point for future evaluation of the efficiency of intensive care units.