title: Comparison of newer scoring systems with the conventional scoring systems in general intensive care population.
abstract: BACKGROUND
  The aim of this study was to assess the performance of Acute Physiology and Chronic Health Evaluation (APACHE) IV, Simplified Acute Physiology Score (SAPS) III, and Mortality Probability Model (MPM) III0 and compare these systems to more widely validated prognosis prediction tools like APACHE II, III, SAPS II, MPM II0 and Sequential Organ Failure Assessment (SOFA) score.
  
  
  METHODS
  The study provided a retrospective analysis of data for all consecutive patients admitted to a medical ICU over a 15-month period. Data related to patient demographics, and that necessary to compute various scores were recorded. Calibration was assessed by calculating Lemeshow-Hosmer goodness-of-fit test. Discrimination was evaluated by calculating the area under curves (AUC). Primary outcome measure was Intensive Care Unit mortality.
  
  
  RESULTS
  Mortality predicted by APACHE IV score was closest to that of actual mortality with a SMR of 0.868 followed by that of MPM III0 (0.794) and SAPS III (0.763) scores. APACHE III (χ2=3.674), with P=0.885 had the best calibration followed by APACHE II (χ2=7.959; P=0.438) and SOFA scores (χ2=8.369; P=0.301). All scores had good efficacy and even though there was no significant difference between AUCs of various scores, MPM III0 (0.947) performed the best followed by APACHE IV (0.928) and MPM II0 (0.928).
  
  
  CONCLUSIONS
  Overall, the newer scoring systems performed better than their older counterparts and were more accurate. Nevertheless, the difference in efficacy was not statistically significant and the choice of scoring system may depend on the ease of use and local preferences.
authors.affiliation: Department of Critical Care Medicine, Max Super Speciality Hospital, New Delhi, India. devenjuneja@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Juneja
authors.forename: O
authors.initials: O
authors.lastname: Singh
authors.forename: P
authors.initials: P
authors.lastname: Nasa
authors.forename: R
authors.initials: R
authors.lastname: Dang
mesh_terms: D018806:APACHE; D000368:Aged; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies