Austrian validation and customization of the SAPS 3 Admission Score.
OBJECTIVE
To test the prognostic performance of the SAPS 3 Admission Score in a regional cohort and to empirically test the need and feasibility of regional customization.


METHODS
Prospective multicenter cohort study.


METHODS
Data on a total of 2,060 patients consecutively admitted to 22 intensive care units in Austria from October 2, 2006 to February 28, 2007.


RESULTS
The database includes basic variables, SAPS 3, length-of-stay and outcome data. The original SAPS 3 Admission Score overestimated hospital mortality in Austrian intensive care patients through all strata of the severity-of-illness. This was true for both available equations, the General and the Central and Western Europe equation. For this reason a customized country-specific model was developed, using cross-validation techniques. This model showed excellent calibration and discrimination in the whole cohort (Hosmer-Lemeshow goodness-of-fit: H = 4.50, P = 0.922; C = 5.61, P = 0.847, aROC, 0.82) as well as in the various tested subgroups.


CONCLUSIONS
The SAPS 3 Admission Score's general equation can be seen as a framework for addressing the problem of outcome prediction in the general population of adult ICU patients. For benchmarking purposes, region-specific or country-specific equations seem to be necessary in order to compare ICUs on a similar level.
Metnitz
Barbara
B
Department of Medical Statistics, Medical University of Vienna, Vienna, Austria.
Schaden
Eva
E
Moreno
Rui
R
Le Gall
Jean-Roger
JR
Bauer
Peter
P
Metnitz
Philipp G H
PG
D000368:Aged; D001317:Austria; D003422:Critical Care / Q000592:standards / Q000706:statistics & numerical data; D003625:Data Collection / Q000592:standards; D003710:Demography; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D011785:Quality Assurance, Health Care / Q000592:standards; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires