• Barbara Metnitz, Eva Schaden, Rui Moreno, Jean-Roger Le Gall, Peter Bauer, Philipp G H Metnitz, and ASDI Study Group.
• Department of Medical Statistics, Medical University of Vienna, Vienna, Austria.
• Intensive Care Med. 2009 Apr 1;35(4):616-22.

ObjectiveTo test the prognostic performance of the SAPS 3 Admission Score in a regional cohort and to empirically test the need and feasibility of regional customization.DesignProspective multicenter cohort study.Patients And SettingData on a total of 2,060 patients consecutively admitted to 22 intensive care units in Austria from October 2, 2006 to February 28, 2007.Measurements And ResultsThe database includes basic variables, SAPS 3, length-of-stay and outcome data. The original SAPS 3 Admission Score overestimated hospital mortality in Austrian intensive care patients through all strata of the severity-of-illness. This was true for both available equations, the General and the Central and Western Europe equation. For this reason a customized country-specific model was developed, using cross-validation techniques. This model showed excellent calibration and discrimination in the whole cohort (Hosmer-Lemeshow goodness-of-fit: H = 4.50, P = 0.922; C = 5.61, P = 0.847, aROC, 0.82) as well as in the various tested subgroups.ConclusionsThe SAPS 3 Admission Score's general equation can be seen as a framework for addressing the problem of outcome prediction in the general population of adult ICU patients. For benchmarking purposes, region-specific or country-specific equations seem to be necessary in order to compare ICUs on a similar level.

25 keywords...

hide…