| Author | Moralez, Giulliana Martines | |
| Author | Rabello, Ligia Sarmet Cunha Farah | |
| Author | Lisboa, Thiago Costa | |
| Author | Lima, Mariza da Fonte Andrade | |
| Author | Hatum, Rodrigo Marques | |
| Author | Marco, Fernando Vinicius Cesar de | |
| Author | Alves, Alessandra | |
| Author | Pinto, Jorge Eduardo da Silva Soares | |
| Author | Araújo, Hélia Beatriz Nunes de | |
| Author | Ramos, Grazielle Viana | |
| Author | Silva, Aline Reis | |
| Author | Fernandes, Guilherme Côrtes | |
| Author | Faria, Guilherme Brenande Alves | |
| Author | Mendes, Ciro Leite | |
| Author | Ramos Filho, Roberto Álvaro | |
| Author | Souza, Valdênia Pereira de | |
| Author | Brasil, Pedro Emmanuel Alvarenga Americano do | |
| Author | Bozza, Fernando A. | |
| Author | Salluh, Jorge Ibrain Figueira | |
| Author | Soares, Marcio | |
| Access date | 2019-02-12T11:51:38Z | |
| Available date | 2019-02-12T11:51:38Z | |
| Document date | 2017 | |
| Citation | 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. 1, p. 1-8, Dec. 2017. | pt_BR |
| ISSN | 2110-5820 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/31560 | |
| Description | On Behalf of the ORCHESTRA Study Investigators. | |
| Sponsorship | This study was supported in part by the National Council for Scientifc and Technological Development (CNPq) (Grant No. 304240/2014-1), Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ) and departmental funds from the D’Or Institute for Research and Education. | |
| Language | eng | pt_BR |
| Publisher | Springer | pt_BR |
| Rights | open access | pt_BR |
| Title | External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1186/s13613-017-0276-3 | |
| Abstract | 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. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Federal University of Rio de Janeiro. PPG Internal Medicine. Rio de Janeiro, RJ, Brazil / Hospital Copa D’Or. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Santa Casa de Misericórdia de Porto Alegre. Complexo Hospitalar. Porto Alegre, RS, Brasil. | pt_BR |
| Affilliation | Hospital Esperança Recife. Recife, PE, Brasil. | pt_BR |
| Affilliation | Hospital Total Cor. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital viValle. São José dos Campos, SP, Brasil. | pt_BR |
| Affilliation | Hospital Rios D’Or. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital Norte D’Or. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital do Coração do Brasil. Brasília, DF, Brasil. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Santa Casa de Misericórdia de Juiz de Fora. Juiz de Fora, MG, Brasil. | pt_BR |
| Affilliation | Hospital Oeste D’Or. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital Universitário Lauro Wanderley. João Pessoa, PB, Brasil. | pt_BR |
| Affilliation | Hospital São Luiz. Unidade Jabaquara. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Complexo Hospitalar de Niterói. Niterói, RJ, Brasil. | pt_BR |
| Affilliation | 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, Brasil. | pt_BR |
| Affilliation | 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, Brasil. | pt_BR |
| Affilliation | 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. | pt_BR |
| Affilliation | 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. | pt_BR |
| Subject | Severity-of-illness scores | pt_BR |
| Subject | Validation | pt_BR |
| Subject | Intensive care units | pt_BR |
| Subject | Outcomes | pt_BR |
| Subject | Standardized mortality rate | pt_BR |
| e-ISSN | 2110-5820 | |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
