Validation of a prognostic score for mortality in elderly patients admitted to Intensive Care Unit.
BACKGROUND
The performance of a prognostic score must be evaluated prior to being used. The aim of the present study was to evaluate the predictive ability of hospital mortality of Simplified Acute Physiology Score 3 (SAPS 3) score in elderly patients admitted to Intensive Care Units (ICUs).


OBJECTIVE
The aim of the present study was to evaluate the SAPS 3 score predictive ability of hospital mortality in elderly patients admitted to ICU.


METHODS
This study was conducted as a prospective cohort, in two mixed ICUs.


METHODS
Two hundred and eleven elderly patients were included.


METHODS
None. We compared the predictive accuracy of SAPS 3 measured at the first hour at ICU and Acute Physiology and Chronic Health Evaluation II (APACHE II) measured with the worst values in the first 24 h at ICU. The patients were followed until hospital discharge.


METHODS
Evaluation of discrimination through area under curve receiver operating characteristic (aROC) and calibration by Hosmer-Lemeshow (HL) test.


RESULTS
The median age was 68 years. The hospital mortality rate was 35.54%. The mean value of SAPS 3 was 62.54 ± 12.51 and APACHE II was 17.46 ± 6.77. The mortality predicted by APACHE II was 24.98 ± 19.96 and for standard SAPS 3 equation 41.18 ± 22.34. The discrimination for SAPS 3 model was aROC = 0.68 (0.62-0.75) and to APACHE II aROC = 0.70 (0.63-0.78). Calibration: APACHE II with HL 10.127P= 0.26, and standard SAPS 3 equation HL 7.204P= 0.51.


CONCLUSIONS
In this study, the prognostic model of SAPS 3 was not found to be accurate in predicting mortality in geriatric patients requiring ICU admission.
Department of Critical Care Medicine, Hospital Especialidades "Antonio Fraga Mouret" Centro Médico Nacional La Raza Mexican, Institute of Social Security, Mexico City, Mexico; Department of Critical Care Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.
Luis Alejandro
LA
Sánchez-Hurtado
Department of Critical Care Medicine, Hospital Especialidades "Antonio Fraga Mouret" Centro Médico Nacional La Raza Mexican, Institute of Social Security, Mexico City, Mexico.
Adrian
A
Ángeles-Veléz
Department of Critical Care Medicine, Hospital Especialidades "Antonio Fraga Mouret" Centro Médico Nacional La Raza Mexican, Institute of Social Security, Mexico City, Mexico.
Brigette Carmen
BC
Tejeda-Huezo
Department of Medicine, Division of Geriatric Medicine, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
Juan Carlos
JC
García-Cruz
Department of Medicine, Clinical Epidemiology Research Unit, Dr. Carlos McGregor Sánchez Regional General Hospital No. 1, Mexican Institute of Social Security, Mexico City, Mexico; Department of Medicine, Faculty of High Studies Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico.
Teresa
T
Juárez-Cedillo
Elderly; Intensive Care Unit; Simplified Acute Physiology Score 3; mortality; prognostic scores