Cross-validation of a Sequential Organ Failure Assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit

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• 作者：Marylou Cá ; rdenas-Turanzas ; MD ; DrPH^a ; Joe Ensor ; PhD^b ; Chris Wakefield ; BS^c ; Karen Zhang ; BS^d ; Susannah Kish Wallace ; MSN ; RN^e ; Kristen J. Price ; MD ; FCCM^a ; Joseph L. Nates ; MD ; MBA ; FCCM^a ; ^{ejlnates@mdanderson.org}
• 关键词：Cancer ; Critically ill ; Mortality ; Validity of results ; Probability ; ROC curve analysis
• 刊名：Journal of Critical Care
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：27
• 期：6
• 页码：673-680
• 全文大小：197 K

文摘

Purpose

This study aims to validate the performance of the Sequential Organ Failure Assessment (SOFA) score to predict death of critically ill patients with cancer.

Material and methods

We conducted a retrospective observational study including adults admitted to the intensive care unit (ICU) between January 1, 2006, and December 31, 2008. We randomly selected training and validation samples in medical and surgical admissions to predict ICU and in-hospital mortality. By using logistic regression, we calculated the probabilities of death in the training samples and applied them to the validation samples to test the goodness-of-fit of the models, construct receiver operator characteristics curves, and calculate the areas under the curve (AUCs).

Results

In predicting mortality at discharge from the unit, the AUC from the validation group of medical admissions was 0.7851 (95 % confidence interval [CI], 0.7437-0.8264), and the AUC from the surgical admissions was 0.7847 (95 % CI, 0.6319-0.937). The AUCs of the SOFA score to predict mortality in the hospital after ICU admission were 0.7789 (95 % CI, 0.74-0.8177) and 0.7572 (95 % CI, 0.6719-0.8424) for the medical and surgical validations groups, respectively.

Conclusions

The SOFA score had good discrimination to predict ICU and hospital mortality. However, the observed underestimation of ICU deaths and unsatisfactory goodness-of-fit test of the model in surgical patients to indicate calibration of the score to predict ICU mortality is advised in this group.