PRELIMINARY-STUDY OF A NONSPECIALIZED SEV ERITY SCORE IN A NONSURGICAL EMERGENCY DEPARTMENT

Evaluation of the prognosis is important in emergency room patients. T wo hundred patients who were admitted through the emergency room were studied to determine whether a reduced version of the Simplified Acute Physiology Score, called SAPS IIr, is effective in predicting mortali ty and the ward of admission. The SAPS IIr includes six clinical and s ix laboratory variables. Youden's test was used to determine optimal t hresholds for mortality and ward of admission. Twenty-three patients w ere admitted to intensive care units and 177 to medical wards. Twenty- three patients died. SAPS IIr scores were higher in patients who died than in those who survived (31.0+/-11.4 and 11.9+/-9.3, respectively; p<0.0001); sensitivity was 86% and specificity 92% for the optimal SAP S IIr threshold (i.e., 24). Patients admitted to intensive care units had higher SAPS IIr scores (27.0+/-13.5) than those who were admitted to medical wards (12.5+/-9.9) (p<0.0001); the optimal SAPS IIr thresho ld was 21 and yielded a sensitivity of 69% and a specificity of 78%. T hese preliminary data suggest that the SAPS IIr score may help predict the short term prognosis and the ward of admission of emergency room patients.