• Rev Bras Anestesiol · Jan 2010

    Applicability of the simplified acute physiology score (SAPS 3) in Brazilian hospitals.

    • João Manoel Silva Junior, Luiz M Sá Malbouisson, Hector L Nuevo, Luiz Gustavo T Barbosa, Lauro Yoiti Marubayashi, Isabel Cristina Teixeira, Antonio Paulo Nassar Junior, Maria Jose Carvalho Carmona, Israel Ferreira da Silva, José Otávio Costa Auler Júnior, and Ederlon Rezende.
    • Serviço de Anestesiologia do Hospital do Servidor Público Estadual Francisco Morato de Oliveira (HSPE), São Paulo, SP. Joao.s@usp.br
    • Rev Bras Anestesiol. 2010 Jan 1; 60 (1): 20-31.

    Background And ObjectivesThe SAPS 3 (Simplified Acute Physiology Score 3) prognostic system is composed of 20 parameters, represented by an acute physiology score and assessment of the previous status, aimed at establishing a predictive mortality index for patients admitted to intensive care units (ICU). The objective of this study was to validate this system and determine its discriminatory power in surgical patients in Brazil.MethodsThis is a prospective study undertaken in two surgical ICUs of two different hospitals over a one-year period; patients younger than 16 years, who stay at the ICU for less than 24 hours, readmitted to the unit, and those admitted for dialysis were excluded from the study. The predictive ability of the SAPS 3 index to differentiate survivors and non-survivors was determined by the ROC curve and calibration by the Hosmer-Lemeshow goodness-of-fit test.ResultsOne thousand three-hundred and ten patients were included in the study. Gastrointestinal surgeries predominated (34.9%). Eighteen was the lower SAPS 3 index and the highest was 154, with a mean of 48.5 +/- 18.1. The predicted and real hospital mortality was 10.3% and 10.8%, respectively; the standardized mortality ratio (SMR) was 1.04 (95%CI = 1.03-1.07). Calibration by the Hosmer and Lemeshow method showed X(2) = 10.47 p = 0.234. The SAPS 3 score that better discriminated survivors and non-survivors was 57, with sensitivity of 75.8% and specificity 86%. Among the patients with SAPS 3 index higher than 57, 73.5% did not survive versus 26.5% who survived (OR= 1.32, 95%CI 1.23-1.42, p < 0.0001).ConclusionsThe SAPS 3 system is valid for the Brazilian population of surgical patients, being a useful indicator of critical patients and to determine greater care in this group.

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