title: Performance of SAPS II and SAPS 3 in intermediate care.
abstract: OBJECTIVE
  The efficacy and reliability of prognostic scores has been described extensively for intensive care, but their role for predicting mortality in intermediate care patients is uncertain. To provide more information in this field, we have analyzed the performance of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 in a single center intermediate care unit (ImCU).
  
  
  METHODS
  Cohort study with prospectively collected data from all patients admitted to a single center ImCU in Pamplona, Spain, from April 2006 to April 2012. The SAPS II and SAPS 3 scores with respective predicted mortality rates were calculated according to standard coefficients. Discrimination was evaluated by calculating the area under receiver operating characteristic curve (AUROC) and calibration with the Hosmer-Lemeshow goodness of fit test. Standardized mortality ratios (SMR) with 95% confidence interval (95% CI) were calculated for each model.
  
  
  RESULTS
  The study included 607 patients. The observed in-hospital mortality was 20.1% resulting in a SMR of 0.87 (95% CI 0.73-1.04) for SAPS II and 0.56 (95% CI 0.47-0.67) for SAPS 3. Both scores showed acceptable discrimination, with an AUROC of 0.76 (95% CI 0.71-0.80) for SAPS II and 0.75 (95% CI 0.71- 0.80) for SAPS 3. Calibration curves showed similar performance based on Hosmer-Lemeshow goodness of fit C-test: (X(2)=12.9, p=0.113) for SAPS II and (X(2)=4.07, p=0.851) for SAPS 3.
  
  
  CONCLUSIONS
  Although both scores overpredicted mortality, SAPS II showed better discrimination for patients admitted to ImCU in terms of SMR.
authors.affiliation: Clínica Universidad de Navarra, Department of Internal Medicine, Division of Intermediate Care and Hospitalists Unit, Navarra, Pamplona, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Lucena
authors.forename: Félix
authors.initials: F
authors.lastname: Alegre
authors.forename: Diego
authors.initials: D
authors.lastname: Martinez-Urbistondo
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Landecho
authors.forename: Ana
authors.initials: A
authors.lastname: Huerta
authors.forename: Alberto
authors.initials: A
authors.lastname: García-Mouriz
authors.forename: Nicolás
authors.initials: N
authors.lastname: García
authors.forename: Jorge
authors.initials: J
authors.lastname: Quiroga
mesh_terms: D000368:Aged; D002138:Calibration; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007380:Intermediate Care Facilities; D008297:Male; D009026:Mortality; D011379:Prognosis; D011785:Quality Assurance, Health Care; D012372:ROC Curve; D013030:Spain