Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/45669
Title: Are prognostic tools losing accuracy? Development and performance of a novel age-calibrated severity scoring system for critically ill patients
Authors: Menezes, Rodrigo C.
Ferreira, Isabella B. B.
Carmo, Thomas A.
Telles, Gabriel P.
Pugas, Paula L. D.
Otero, Matheus L.
Arriaga, Maria B.
Fukutani, Kiyoshi Ferreira
Neto, Licurgo P.
Agareno, Sydney
Filgueiras Filho, Nivaldo M.
Akrami, Kevan M.
Andrade, Bruno Bezerril de
Affilliation: Hospital de Cidade. Núcleo de Pesquisa, Ensino e Comunicação. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Universidade do Estado da Bahia. Salvador, BA, Brasil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Universidade Salvador. Salvador, BA, Brasil.
Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Hospital de Cidade. Intensive Care Unit. Salvador, BA, Brazil.
Hospital de Cidade. Núcleo de Pesquisa, Ensino e Comunicação. Salvador, BA, Brasil / Universidade do Estado da Bahia. Salvador, BA, Brasil / Universidade Salvador. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. .lvador, BA, Bahia, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / University of California. Division of Infectious Diseases and Pulmonary Critical Care and Sleep Medicine. Department of Medicine. San Diego, CA, United States of America.
Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Universidade Salvador. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Abstract: This study aimed to assess the performance of a commonly used ICU severity score (SAPS3) and determine whether an alternative scoring system may be more accurate across all age strata. Methods Retrospective cohort study in a general ICU in Brazil. A secondary analysis was performed with clinical and epidemiological data, present in the first 24 hours of unit admission. Then, a binary logistic regression, followed by cross-validation, was made to develop a novel prognostic tool. ICU mortality was the primary outcome evaluated. Results A total of 3042 patients were included over the study period between August 2015 and July 2018 with a median age of 67 ± 18.4 years. SAPS3 performed fairly in prediction of ICU mortality, particularly in the 80 years or older subset. Multivariable regression identified variables independently associated with mortality that were used to develop the Age Calibrated ICU Score (ACIS) tool that performed similarly to SAPS3 across age categories, being slightly superior in the very elderly population (AUC 0.80 vs 0.72).Conclusions The ACIS offers a robust and simple tool to predict ICU mortality, particularly in an increasingly elderly critical care population.
Keywords: Prognostic
Intensive Care Units
SAPS3
Brazil
Mortality
Care population
keywords: Prognóstico
Unidades de Terapia Intensiva
SAPS3
Brasil
Mortalidade
População idosa
Issue Date: 2020
Publisher: Public Library of Science
Citation: MENEZES, Rodrigo C. et al. Are prognostic tools losing accuracy? Development and performance of a novel age-calibrated severity scoring system for critically ill patients. Plos One, p. 1-10, 2020.
DOI: 10.1371/journal.pone.0240793
ISSN: 1932-6203
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos
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