Article
Customization and external validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) in Brazilian critically ill patients
Registro en:
ZAMPIERI, Fernando G. et al. Customization and external validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) in Brazilian critically ill patients. Journal of Critical Care, v. 59, p. 94-100, 2020.
0883-9441
10.1016/j.jcrc.2020.05.016
Autor
Zampieri, Fernando G.
Granholm, Anders
Møller, Morten Hylander
Scotti, Alexandre Vaz
Alves, Alessandra
Cabral, Maurício Magalhães
Sousa, Marcelo Ferreira
Balieiro, Henrique Miller
Hortala, Carlos Cesar
Filho, Edison Moraes Rodrigues
Perecmanis, Eric
Magalhães Menezes, Márcia Adélia
Moreira, Carlos Eduardo Nassif
Moralez, Giulliana Martines
Bafi, Antônio Tonete
Carvalho, Clayton Barbieri
Salluh, Jorge Ibrain Figueira
Bozza, Fernando Augusto
Perner, Anders
Soares, Marcio
Resumen
Purpose: To customize and externally validate the recently proposed Simplified Mortality Score for the ICU (SMS-ICU, a simple score for 90-day mortality that has no need for ancillary testing results) for in-hospital mortality and to compare its performance to SAPS 3.
Material and methods: We used data from two distinct large cohorts of adult Brazilian patients with unplanned ICU admissions to perform a first-level customization (43,017 patients admitted to 78 ICUs) of the original SMS-ICU score for in-hospital mortality and, sequentially, externally validate it (313,365 patients admitted to 99 ICUs). Performance of SMS-ICU was assessed through measurements of discrimination and calibration and compared with SAPS 3.
Results: In the validation cohort, median SMS-ICU was 13 (IQR 8-16) points and median SAPS 3 was 44 (IQR 36-51). Discrimination of SMS-ICU was good (AUC 0.817; 95% CI 0.814-0.819) but slightly lower than of SAPS 3 (AUC 0.845; 95% CI 0.843-0.848;). The customized SMS-ICU predictions were comparable to SAPS 3 in terms of calibration.
Conclusion: In this external validation of the SMS-ICU in a large Brazilian cohort, we observed good discrimination of SMS-ICU and acceptable calibration after first-level customization. SMS-ICU can be used as a measure of illness severity for acutely admitted ICU patients in clinical studies. 2030-01-01