| Validation of four prognostic scores in patients with cancer admitted to Brazilian intensive care units: results from a prospective multicenter study. | |
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MedLine Citation:
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PMID: 20221751 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of the present study was to validate the Simplified Acute Physiology Score II (SAPS II) and 3 (SAPS 3), the Mortality Probability Models III (MPM(0)-III), and the Cancer Mortality Model (CMM) in patients with cancer admitted to several intensive care units (ICU). DESIGN: Prospective multicenter cohort study. SETTING: Twenty-eight ICUs in Brazil. PATIENTS: Seven hundred and seventeen consecutive patients (solid tumors 93%; hematological malignancies 7%) included over a 2-month period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Discrimination was assessed by area under receiver operating characteristic (AROC) curves and calibration by Hosmer-Lemeshow goodness-of-fit test. The main reasons for ICU admission were postoperative care (57%), sepsis (15%) and respiratory failure (10%). The ICU and hospital mortality rates were 21 and 30%, respectively. When all 717 patients were evaluated, discrimination was superior for both SAPS II (AROC = 0.84) and SAPS 3 (AROC = 0.84) scores compared to CMM (AROC = 0.79) and MPM(0)-III (AROC = 0.71) scores (P < 0.05 in all comparisons). Calibration was better using CMM and the customized equation of SAPS 3 score for South American countries (CSA). MPM(0)-III, SAPS II and standard SAPS 3 scores underestimated mortality (standardized mortality ratio, SMR > 1), while CMM tended to overestimation (SMR = 0.48). However, using the SAPS 3 for CSA resulted in more precise estimations of the probability of death [SMR = 1.02 (95% confidence interval = 0.87-1.19)]. Similar results were observed when scheduled surgical patients were excluded. CONCLUSIONS: In this multicenter study, the customized equation of SAPS 3 score for CSA was found to be accurate in predicting outcomes in cancer patients requiring ICU admission. |
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Authors:
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Márcio Soares; Ulisses V A Silva; José M M Teles; Eliézer Silva; Pedro Caruso; Suzana M A Lobo; Felipe Dal Pizzol; Luciano P Azevedo; Frederico B de Carvalho; Jorge I F Salluh |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-03-11 |
Journal Detail:
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Title: Intensive care medicine Volume: 36 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-10 Completed Date: 2010-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1188-95 Citation Subset: IM |
Affiliation:
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ICU, Hospital de Câncer-I, Instituto Nacional de Câncer, Centro de Tratamento Intensivo, 10 degrees Andar; Pça. Cruz Vermelha, 23, Rio de Janeiro, RJ, CEP 20230-130, Brazil. marciosoaresms@yahoo.com.br |
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| MeSH Terms | |
Descriptor/Qualifier:
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APACHE* Brazil / epidemiology Female Hospital Mortality Humans Intensive Care Units Male Middle Aged Neoplasms / diagnosis*, mortality Observation Probability Prognosis Prospective Studies ROC Curve Reproducibility of Results |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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