title: Comparison of severity-of-illness scores in critically ill obstetric patients: a 6-year retrospective cohort.
abstract: OBJECTIVE
  The purpose of this research was to evaluate the discrimination and calibration of mortality prediction of Simplified Acute Physiology Score 2, Simplified Acute Physiology Score 3, Mortality Probability Model II, and Mortality Probability Model III in peripartum women.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Rafael Calvo Maternity Hospital, a large teaching hospital in Cartagena (Colombia).
  
  
  METHODS
  All obstetric patients admitted to the ICU from 2006 to 2011.
  
  
  METHODS
  None.
  
  
  RESULTS
  Seven hundred twenty-six obstetric critical care patients were included. All scores showed good discrimination (area under the receiver operator characteristic curve > 0.86). Simplified Acute Physiology Score 2, Simplified Acute Physiology Score 3, and Mortality Probability Model III inaccurately estimated mortality. The only mortality prediction score that showed good calibration through mortality ratio and Hosmer-Lemeshow test was Mortality Probability Model II. Mortality ratio for Mortality Probability Model II was 0.88 (95% CI, 0.60-1.25). Hosmer-Lemeshow test was not significant (p = 0.571).
  
  
  CONCLUSIONS
  Simplified Acute Physiology Score 2 and Simplified Acute Physiology Score 3 overestimate mortality in obstetric critical care patients. Mortality Probability Model III was inadequately calibrated. Mortality Probability Model II showed good fit to predict mortality in a developing country setting. Future studies in developed and developing countries are needed to further confirm our findings.
authors.affiliation: 1Intensive Care Unit, Gestion Salud S.A., Cartagena, Colombia. 2Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidados Intensivos y Obstetricia, GRICIO, Universidad de Cartagena, Cartagena, Colombia. 3Department of Medicine, Women's Medicine Collaborative, The Miriam Hospital, Brown University, Providence, RI.
authors.forename: José
authors.initials: J
authors.lastname: Rojas-Suarez
authors.forename: Angel J
authors.initials: AJ
authors.lastname: Paternina-Caicedo
authors.forename: Jezid
authors.initials: J
authors.lastname: Miranda
authors.forename: Ray
authors.initials: R
authors.lastname: Mendoza
authors.forename: Carmelo
authors.initials: C
authors.lastname: Dueñas-Castel
authors.forename: Ghada
authors.initials: G
authors.lastname: Bourjeily
mesh_terms: D018806:APACHE; D000046:Academic Medical Centers; D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D015331:Cohort Studies; D003105:Colombia; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000706:statistics & numerical data; D008428:Maternal Mortality; D058725:Peripartum Period; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis