title: Validation of the Simplified Acute Physiology Score 3 scoring system in a Korean intensive care unit.
abstract: OBJECTIVE
  The Simplified Acute Physiology Score (SAPS) 3 was recently proposed to reflect contemporary changes in intensive care practices. SAPS 3 features customized equations for the prediction of mortality in different geographic regions. However, the usefulness of SAPS 3 and its customized equation (Australasia SAPS 3) have never been externally validated in Korea. This study was designed to validate SAPS 3 and Australasia SAPS 3 for mortality prediction in Korea.
  
  
  METHODS
  A retrospective analysis of the prospective intensive care unit (ICU) registry was conducted in the medical ICU of Samsung Medical Center. Calibration and discrimination were determined by the Hosmer-Lemeshow test and area under the receiver operating characteristic (aROC) curve from 633 patients.
  
  
  RESULTS
  The mortalities (%) predicted by SAPS 3, Australasia SAPS 3, and SAPS II were 42 ± 28, 39 ± 27 and 37 ± 31, respectively. The calibration of SAPS II was poor (p = 0.003). SAPS 3 and Australasia SAPS 3 were appropriate (p > 0.05). The discriminative power of all models yielded aROC values less than 0.8.
  
  
  CONCLUSIONS
  In Korea, mortality rates predicted using general SAPS 3 and Australasia SAPS 3 exhibited good calibration and modest discrimination. However, Australasia SAPS 3 did not improve the mortality prediction. To better predict mortality in Korean ICUs, a new equation may be needed specifically for Korea.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lim
authors.forename: Cho Rom
authors.initials: CR
authors.lastname: Ham
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.forename: Suhyun
authors.initials: S
authors.lastname: Kim
authors.forename: Maeng Real
authors.initials: MR
authors.lastname: Park
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Um
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007723:Korea; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index