The predictive power of SAPS-3 and SOFA scores and their relations with patient outcomes in the Surgical Intensive Care Unit
İbrahim Mungan, Şerife Bektaş, Mine Altınkaya Çavuş, Sema Sarı, Sema Turan
Intensive Care Unit, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
Abstract
Objective: Individual risk of surgical patients is more often underestimated and there is not an absolute criterion demonstrating which patient deserves intensive care. Since a nominative assessment of these patients to quantify the intensity of critical illness is not appropriate, prognostic scores are used to assess the mortality rate and prognosis for critical patients including surgical ones. This study aimed to test the calibration power of SAPS-3 score and SOFA score of surgical patients undergoing gastrointestinal surgery, and identify any relation with patient outcomes in the department of surgical ICU.
Material and Methods: This retrospective observational study was conducted during the period between August 2017 and December 2017. It was performed at a Gastroenterological Surgical ICU, a tertiary care hospital in Ankara, Türkiye. To calculate SAPS-3 and SOFA score, physiological data and laboratory analysis on the day of ICU admission were used. Records were reviewed from hospitalization to medical discharge or hospital mortality. Statistical analysis included Mann Whitney U-test and ROC-curves to predict 30-day mortality.
Results: A total of 233 patients admitted to the Gastroenterological Surgical ICU were included into the study and the main reason for ICU admission was surgical problems. Mortality rate was 2.6 % (6 patients). Average SAPS -3 score was 32.5 and SOFA score was 30.1. A significant correlation was observed with the SAPS-3 score, but not with the SOFA score statistically in mortality as a dependent factor. The discriminative power, assessed using the AUC and the probability of death estimation, was satisfactory with the SAPS-3 scores (AUC 0.754) while it was lower with the SOFA score (AUC 0.631)
Conclusion: We found that SAPS-3 score was significantly correlated not only with mortality rate, but also with LOS in the ICU. Nonetheless, SOFA score was not related to mortality, but related to LOS in the ICU. Prognostic score systems are used to estimate mortality but they may be used to identify LOS in the ICU and postoperative complications. It can be concluded that SAPS-3 and SOFA scores may be used to prognosticate postoperative ICU requirement.
Keywords: Simplified acute physiology score, sequential organ failure assessment, surgical intensive care unit, mortality, predictive
Cite this article as: Mungan İ, Bektaş Ş, Altınkaya Çavuş M, Sarı S, Turan S. The predictive power of SAPS 3 and SOFA scores and their relations with patient outcomes in the surgical intensive care unit. Turk J Surg 2019; 35 (2): 124-130
Since our study was in the category of non-interventional clinical research with its retrospective structure, no ethics committee approval was applied.
In extra formal consent other than the patients had given prior to hospitalization was not required for the current study since it was a case-control medical record review. No change in our current clinical practice and no randomization was performed.
Externally peer-reviewed.
Consept - İ.M., Ş.B.; Design - İ.M., M.Ç.; Supervision - S.T., Ş.B; Resource - İ.M., S.S; Materials - İ.M., M.Ç.; Data Collection and/or Processing - İ.M., M.Ç., Ş.B., S.S; Analysis and Interpretation - İ.M., S.T., S.S.; Literature Search - İ.M., Ş.B.; Writing Manuscript - İ.M.; Critical Reviews - İ.M., S.T.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.