A COMPARISON OF SEVERITY OF ILLNESS SCORING SYSTEMS FOR INTENSIVE-CARE UNIT PATIENTS - RESULTS OF A MULTICENTER, MULTINATIONAL STUDY

Authors
CASTELLA X ARTIGAS A BION J KARI A BENZER H HUBER C ALEXANDER JP DELANDE M LEDOUX D CANIVET JL DAMAS P DEMEYER I VISSERS K DUGERNIER T HUYGHENS L DILTOUR M DEWIT N NAGLER J COOLS F NOLLET G VERBEKE J POELAERT J COLLARDYN F LATERRE PF DOUGNAC A REYNAERT M RUTSAERT R COLEMONT L SCHETZ M LAUWERS P HAMILTON S NORRIS C SHUSTACK A JOHNSTON R KONOPAD E HANNONEN P HERSIO K KAIRI P KLOSSNER J SAARELA E VAHAMURTO M ARICE C BEDOCQ B BLETTERY B MISSET B CARLET J MIER L DREYFUSS D FOSSE JP GARO B DEMINGEON G HOLZHAPFEL L KOPFERSCHMITT J MAHUL P NITEMBERG G PLOUVIER F SAULNIER F VILLERS D WIEDECK H BURCHARDI H KLINGLER H DICK W BROST F ECKART J WENGERT P GELGER K ARMBRUSTER K KAMP HD ROTHE M LANDAUER B SCHMID TO PETER K FORST H PIPER C REINHART K RUDOLPH T RUGHEIMER E PSCHEIDL E SCHMITZ J SCHUSTER HP BODMANN KF STOBER D DRESSLER C ALBERTARIO F CARNEVALE L BASSI F GRAZIANI BM PALLAVICINI FB CASSINI C CINELLA G BRIENZA A CONTI G DEBLASI A FIANDRI MT COSCO D FUMAGALLI R AVALLI L GIUDICI D GALLIOLI G CAPUZZO M RAGAZZI R VOLTA CA GUARINO A MERLI G SERRA L FASIOLO S IAPICHINO G ROTELLI S LACQUANITI L MORETTI T MELOTTI R NEGRO G MERGONI M SACCANI A RAVIZZA A CASELLA G RIPAMONTI D FAVERO A SIMINI G MANUALI A VERNERO S VIALE A VESCONI S SICIGNANO A BRUINING HA DEHAAS J DEJONG D DEJONG M HAANSTRA WP HULSTAERT PF JAIRAM R VANDALEN R VANDERGEEST S WOITTIEZ AJJ ZWAVELING JH ABIZANDA R BALERDI B SOCIAS L MESTRE J BONET A ALVAREZ A BOVEDA JL MANZANARES I SALGADO I CABRE L CARRASCO G CASANOVAS M FARAIDUN E BAUSILI JM CERDA M IBARS M GIMENO C PRIETO AD TORRADO H GUARDIOLA JJ BOQUE C GUIRADOALAIZ M ITURBE F BARBERA C RABASSO C CABALLERO JMN ROGLAN A RUIZ J GARCIA L SARMIENTO X TOBOSO JM SOLSONA J VAZQUEZ A NOLLA M BAUMANN PC VONWILLER HM DOMENIGHETTI G ERBA D CHEVROLET JC JOLLIET P CHIOLERO R MESSIKOMMER A ENRICO JF KEHTARI R DETORRENTE A KOCHER A LUPI G FRUTIGER A REIGNER M RITZ R DURRER S PERRET CH SCHALLER MD SUTER P RICOU B BOWDEN M GARRARD C RANDALLS B WILSON I ADELMAN M MILLER RA QUINONES B BAER CL SCHWAMACHER J RENNER L COX PM PRATO S FEIN IA VEEDER A GETTINGER A HOLMES K ASTIZ ME SAXON J DEGENT G GROSSBARD L RUCHTI R GUTIERREZ G CLARK C WITHERSPOON J HARRIS F HIGGINS M JASTREMSKI MS MILEWSKI A BUNCH K KARRAS G BARGHOUD C RICHARD N BOOTH FVM KERINS R BOOTH J NASRAWAY SA SOTTILE FD SIGEL P ORTIZ CR CROMILLER J PORTER KA RAFKIN H ERMAKOV S RETCHIN S REINES HD CASADO M ROGOVE H MORROW S CHUPKA K FOSTER E SCHWAITZBERG SD HAYES J SCARAMUZZI J SMITH JL BURNS R HAMMAKER D TERES D DESROSIERS C MOINEAU A THOMPSON D SIPPERLY ME HEISELMAN D HOFER T VIDOVICH R ODONNELL JM GRAY A DAVIS FG TONNESEN AS CRONIN LS JENNINGS C
Citation
X. Castella et al., A COMPARISON OF SEVERITY OF ILLNESS SCORING SYSTEMS FOR INTENSIVE-CARE UNIT PATIENTS - RESULTS OF A MULTICENTER, MULTINATIONAL STUDY, Critical care medicine, 23(8), 1995, pp. 1327-1335
Citations number
28
Categorie Soggetti
Emergency Medicine & Critical Care
Journal title
Critical care medicine → ACNP
ISSN journal
00903493
Volume
23
Issue
8
Year of publication
1995
Pages
1327 - 1335
Database
ISI
SICI code
0090-3493(1995)23:8<1327:ACOSOI>2.0.ZU;2-6
Abstract
Objective: To compare the performance of three severity of illness sco ring systems used commonly for intensive care unit (ICU) patients in a large international data set. The systems analyzed were versions II a nd III of the Acute Physiology and Chronic Health Evaluation (APACHE) system, versions I and II of the Simplified Acute Physiology Score (SA PS), and versions I and II of the Mortality Probability Model (MPM), c omputed at admission and after 24 hrs in the ICU. Design: A multicente r, multinational cohort study. Setting: One hundred thirty-seven ICUs in 12 European and North American countries. Patients: During a 3-mont h period, 14, 745 patients were consecutively admitted to 137 ICUs enr olled in the study. Interventions: Collection of information necessary to compute the APACHE II and APACHE III scores, SAPS I and SAPS II, a nd MPM I and MPM II scores. Patients were followed until hospital disc harge. Statistical comparison, including indices of calibration (goodn ess-of-fit) and discrimination (are!a under the receiver operating cha racteristic curve). Measurements and Main Results: Despite having acce ptable receiver operating characteristic areas, the older versions of the systems analyzed (APACHE II, SAPS, and MPM I computed at admission -MPM I computed after 24 hrs in the ICU) demonstrated poor calibration for the whole database. The new versions of the systems (SAPS II and MPM II) were superior to their older counterparts. This superiority is reflected by larger receiver operating characteristic areas and bette r fit. The APACHE III system improved its receiver operating character istic area compared with the APACHE II system, which showed the best f it of the old systems analyzed. Conclusions: The new versions of the s everity systems analyzed (APACHE III, SAPS II, MPM II) perform better than their older counterparts (APACHE II, SAPS I, and MPM I). APACHE I I, SAPS II, and MPM II show good discrimination and calibration in thi s international database.