• José Rojas-Suarez, Angel J Paternina-Caicedo, Jezid Miranda, Ray Mendoza, Carmelo Dueñas-Castel, and Ghada Bourjeily.
• 1Intensive Care Unit, Gestion Salud S.A., Cartagena, Colombia. 2Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidados Intensivos y Obstetricia, GRICIO, Universidad de Cartagena, Cartagena, Colombia. 3Department of Medicine, Women's Medicine Collaborative, The Miriam Hospital, Brown University, Providence, RI.
• Crit. Care Med. 2014 May 1; 42 (5): 1047-54.

ObjectiveThe purpose of this research was to evaluate the discrimination and calibration of mortality prediction of Simplified Acute Physiology Score 2, Simplified Acute Physiology Score 3, Mortality Probability Model II, and Mortality Probability Model III in peripartum women.DesignA retrospective cohort study.SettingRafael Calvo Maternity Hospital, a large teaching hospital in Cartagena (Colombia).PatientsAll obstetric patients admitted to the ICU from 2006 to 2011.InterventionsNone.Measurements And Main ResultsSeven hundred twenty-six obstetric critical care patients were included. All scores showed good discrimination (area under the receiver operator characteristic curve > 0.86). Simplified Acute Physiology Score 2, Simplified Acute Physiology Score 3, and Mortality Probability Model III inaccurately estimated mortality. The only mortality prediction score that showed good calibration through mortality ratio and Hosmer-Lemeshow test was Mortality Probability Model II. Mortality ratio for Mortality Probability Model II was 0.88 (95% CI, 0.60-1.25). Hosmer-Lemeshow test was not significant (p = 0.571).ConclusionsSimplified Acute Physiology Score 2 and Simplified Acute Physiology Score 3 overestimate mortality in obstetric critical care patients. Mortality Probability Model III was inadequately calibrated. Mortality Probability Model II showed good fit to predict mortality in a developing country setting. Future studies in developed and developing countries are needed to further confirm our findings.

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