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© 2020 Menezes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Objective

This study aimed to assess the performance of a commonly used ICU severity score (SAPS3) and determine whether an alternative scoring system may be more accurate across all age strata.

Methods

Retrospective cohort study in a general ICU in Brazil. A secondary analysis was performed with clinical and epidemiological data, present in the first 24 hours of unit admission. Then, a binary logistic regression, followed by cross-validation, was made to develop a novel prognostic tool. ICU mortality was the primary outcome evaluated.

Results

A total of 3042 patients were included over the study period between August 2015 and July 2018 with a median age of 67 ± 18.4 years. SAPS3 performed fairly in prediction of ICU mortality, particularly in the 80 years or older subset. Multivariable regression identified variables independently associated with mortality that were used to develop the Age Calibrated ICU Score (ACIS) tool that performed similarly to SAPS3 across age categories, being slightly superior in the very elderly population (AUC 0.80 vs 0.72).

Conclusions

The ACIS offers a robust and simple tool to predict ICU mortality, particularly in an increasingly elderly critical care population.

Details

Title
Are prognostic tools losing accuracy? Development and performance of a novel age-calibrated severity scoring system for critically ill patients
Author
Menezes, Rodrigo C; Ferreira, Isabella B B; Carmo, Thomas A; Telles, Gabriel P; Pugas, Paula L D; Otero, Matheus L; Arriaga, Maria B; Fukutani, Kiyoshi F; Neto, Licurgo P; Agareno, Sydney; Nivaldo M Filgueiras Filho; Akrami, Kevan M; Andrade, Bruno B
First page
e0240793
Section
Research Article
Publication year
2020
Publication date
Nov 2020
Publisher
Public Library of Science
e-ISSN
19326203
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2457581575
Copyright
© 2020 Menezes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.