Support & Downloads

Quisque actraqum nunc no dolor sit ametaugue dolor. Lorem ipsum dolor sit amet, consyect etur adipiscing elit.

s f

Contact Info
198 West 21th Street, Suite 721
New York, NY 10010
youremail@yourdomain.com
+88 (0) 101 0000 000
Follow Us

Sem categoria

SAPS 3 performance in cancer patients admitted to an intensive care unit in Brazil

Autor: L. Taniguchi, E. Siqueira
Intensive care unit, Hospital Sirio Libanes, Sao Paulo, Brazil
Correspondência: L. Taniguchi
Intensive Care Medicine Experimental 2019, 7(Suppl 3):001246
Data: 2019

INTRODUÇÃO

Simplified Acute Physiology Score 3 (SAPS 3) is the
most accurate prognostic model for Brazil [1]. However, recent evaluation
of its performance in solid cancer patients has not been performed
in our country.

OBJETIVOS

To compare the performance of SAPS 3 in patients with and without solid cancer admitted to the intensive care unit (ICU) of a comprehensive oncological hospital in Brazil.

MÉTODOS

Retrospective cohort analysis of Epimed® administrative database of adult patients (>18 years) first admission to the intensive care unit (ICU) of Hospital Sírio Libanês (São Paulo, Brazil) from 2012 to 2016. Patients were categorized according to the presence of solid cancer at ICU admission. Hematological patients were excluded. We evaluated discrimination using the area under the receiver operating characteristic curve (AUROC) and the agreement between observed and expected mortality rates
(calibration) using the calibration belt.

RESULTADOS

We studied 7,390 patients (age 66.1±18.4 years, 54.1% male, SAPS 3 score 41.6± 13.3, 41.6% had cancer, 12.1% died during hospitalization). Cancer patients were younger compared to non-cancer patients (62.6±16.5 years vs 68.7±19.3 years respectively, p<0.001), had lower SAPS 3 (40.9±14 vs 42.1±12.8 respectively, p<0.001), were admitted more frequently after elective surgery (60.6% vs 24.9%, p<0.001), but had higher hospital mortality (14.1% vs 10.6%, p<0.001). SAPS 3 discrimination was better
for cancer patients (AUROC = 0.85) than for non-cancer patients (AUROC = 0.79) (p < 0.001). After we applied the calibration belt, we observed that in cancer patients the SAPS 3 match the average observed rates for the confidence level of 95%. In noncancer
patients the SAPS 3 overestimated mortality in those with low-middle risk (figure).

CONCLUSÃO

SAPS 3 has different performances in cancer and noncancer patients in our single-center cohort.

REFERÊNCIA

1. Moralez GM, Rabello LSCF, Lisboa TC, Lima MDFA, Hatum RM, De Marco FVC, et al. External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs. Ann Intensive Care. 2017;7:53.