Using patient admission characteristics alone to predict mortality of critically ill patients: A comparison of 3 prognostic scores

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• 作者：Kwok M. Ho ; MPH ; PhD^a ; ^b ; ^c ; ^{kwok.ho@health.wa.gov.au" class="auth_mail" title="E-mail the corresponding author} ; Teresa A. Williams ; PhD^d ; ^{teresa.williams@curtin.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Yusra Harahsheh ; BSc (Hons)^a ; ^{Yusra.Harahsheh@health.wa.gov.au" class="auth_mail" title="E-mail the corresponding author} ; Thomas L. Higgins ; MD ; MBA^e ; ^f ; ^{Thomas.Higgins@baystatehealth.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Outcome ; Prognosis ; Prediction ; Risk adjustment ; Severity of illness
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：31
• 期：1
• 页码：21-25
• 全文大小：353 K

文摘

This study compared the performance of 3 admission prognostic scores in predicting hospital mortality.

Materials and methods

Patient admission characteristics and hospital outcome of 9549 patients were recorded prospectively. The discrimination and calibration of the predicted risks of death derived from the Simplified Acute Physiology Score (SAPS III), Admission Mortality Prediction Model (MPM₀ III), and admission Acute Physiology and Chronic Health Evaluation (APACHE) II were assessed by the area under the receiver operating characteristic curve and a calibration plot, respectively.

Measurements and main results

Of the 9549 patients included in the study, 1276 patients (13.3%) died after intensive care unit admission. Patient admission characteristics were significantly different between the survivors and nonsurvivors. All 3 prognostic scores had a reasonable ability to discriminate between the survivors and nonsurvivors (area under the receiver operating characteristic curve for SAPS III, 0.836; MPM₀ III, 0.807; admission APACHE, 0.845), with best discrimination in emergency admissions. The SAPS III model had a slightly better calibration and overall performance (slope of calibration curve, 1.03; Brier score, 0.09; Nagelkerke R², 0.297) compared to the MPM₀ III and admission APACHE II model.

Conclusions

All 3 intensive care unit admission prognostic scores had a good ability to predict hospital mortality of critically ill patients, with best discrimination in emergency admissions.