Ward mortality after ICU discharge: a multicenter validation of the Sabadell score.
BACKGROUND
Tools for predicting post-ICU patients' outcomes are scarce. A single-center study showed that the Sabadell score classified patients into four groups with clear-cut differences in ward mortality.


OBJECTIVE
To validate the Sabadell score using a prospective multicenter approach.


METHODS
Thirty-one ICUs in Spain.


METHODS
All patients admitted in the 3-month study period. We recorded variables at ICU admission (age, sex, severity of illness, and do-not-resuscitate orders), during the ICU stay (ICU-specific treatments, ICU-acquired infection, and acute renal failure), and at ICU discharge (Sabadell score). Statistical analyses included one-way ANOVA and multiple regression analysis with ward mortality as the dependent variable.


RESULTS
We admitted 4,132 patients (mean age 61.5 +/- 16.7 years) with mean predicted mortality of 23.8 +/- 22.7%; 545 patients (13%) died in the ICU and 3,587 (87%) were discharged to the ward. Overall ward mortality was 6.7%; ward mortality was 1.5% (36/2,422) in patients with score 0 (good prognosis), 9% (64/725) in patients with score 1 (long-term poor prognosis), 23% (79/341) in patients with score 2 (short-term poor prognosis), and 64% (63/99) in patients with score 3 (expected hospital death). Variables associated with ward mortality in the multivariate analysis were predicted risk of death (OR 1.016), ICU readmission (OR 5.9), Sabadell score 1 (OR 4.7), Sabadell score 2 (OR 15.7), and Sabadell score 3 (OR 107.2).


CONCLUSIONS
We confirm the ability of the Sabadell score at ICU discharge to define four groups of patients with very different likelihoods of hospital survival.
Fernandez
Rafael
R
CIBER Enfermedades Respiratorias, ICU, Hospital Sant Joan de Deu, Fundació Althaia, Manresa, Spain. rfernandezf@althaia.cat
Serrano
Jose Manuel
JM
Umaran
Isabel
I
Abizanda
Ricard
R
Carrillo
Andres
A
Lopez-Pueyo
Maria Jesus
MJ
Rascado
Pedro
P
Balerdi
Begoña
B
Suberviola
Borja
B
Hernandez
Gonzalo
G
D018806:APACHE; D000368:Aged; D000704:Analysis of Variance; D016638:Critical Illness / Q000145:classification / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015203:Reproducibility of Results; D013030:Spain / Q000453:epidemiology