Aa. Elsolh et Bjb. Grant, A COMPARISON OF SEVERITY OF ILLNESS SCORING SYSTEMS FOR CRITICALLY ILL OBSTETRIC PATIENTS, Chest, 110(5), 1996, pp. 1299-1304
Study objective: To evaluate the predictive ability of three scoring s
ystems, acute physiology and chronic health evaluation (APACHE II), si
mplified acute physiology score (SAPS II), and mortality probability m
odels (MPM II) in critically ill obstetric patients compared to a cont
rol group of nonobstetric female patients of similar age group (range,
17 to 41 years). Design: A retrospective medical chart review of obst
etric and nonobstetric female patients between 17 and 41 years of age,
Setting: Two university hospitals, Patients: Ninety-three obstetric p
atients and 96 nonobstetric female patients were identified from 12,74
0 consecutive ICU admissions. Results: The actual mortality of the obs
tetric and the nonobstetric group was 10.8% (95% confidence interval [
CI], 5.3 to 19.0%) and 12.0% (95% CI, 6.6 to 21.0%), respectively, The
observed mortality was not statistically different from the mortality
predicted by APACHE II, SAPS II, and MPM;I II (14.146, 7.8%, and 9.1%
for the obstetric group and 10.9%, 9.0%, and 9.9% for the nonobstetri
c group). Predictive accuracy was assessed by the c-index, which is eq
uivalent to the area under the receiver operator characteristic (ROC)
curve. There mere no significant differences in the c-index: for APACH
E II, SAPS II, and MPM II within or between the obstetric group ([mean
+/-SE], 0.93+/-0.02, 0.90+/-0.04, and 0.91+/-0.04, respectively) and t
he nonobstetric group (0.91+/-0.02, 0,95+/-0.03, and 0.96+/-0.02, resp
ectively). Conclusions: We conclude that APACHE II, SAPS II, and MPM I
I assess the ICU outcome of critically il obstetric patients as accura
tely as nonobstetric critically ill female patients of similar age gro
up.