Comparison of three severity scores for critically ill cancer patients.
OBJECTIVE
To compare three scoring systems, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Simplified Acute Physiology Score (SAPS) II and a modified Mortality Probability Model II (ICU cancer mortality model, ICMM) for their prognostic value for mortality during hospital stay in a group of cancer patients admitted to a medical ICU.


METHODS
Prospective cohort study.


METHODS
Medical ICU of a tertiary care hospital.


METHODS
Two hundred forty-two consecutive cancer patients admitted to the ICU.


RESULTS
Variables included in APACHE II, SAPS II and the ICMM scores as well as demographic data were assessed during the first 24 h of stay in the ICU. Hospital mortality was measured; it was 44%. Calibration for all three scoring systems was acceptable, SAPS II yielded a significantly superior discrimination between survivors and non-survivors. The areas under the receiver operating characteristic curves were 0.776 for APACHE II, 0.825 for SAPS II and 0.698 for the ICMM.


CONCLUSIONS
The SAPS II was superior to APACHE II and ICMM. The newly developed ICMM does not improve mortality prediction in critically ill cancer patients.
Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Peter
P
Schellongowski
Michael
M
Benesch
Thomas
T
Lang
Friederike
F
Traunmüller
Christian
C
Zauner
Klaus
K
Laczika
Gottfried J
GJ
Locker
Michael
M
Frass
Thomas
T
Staudinger
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D015996:Survival Rate