External validation of the SAPS II, APACHE II and APACHE III prognostic models in South England: a multicentre study

Beck, Dieter; Smith, Gary B.; Pappachan, John; Millar, B. W.

doi:10.1007/s00134-002-1607-9

Cited by 134 publications

(107 citation statements)

References 47 publications

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“…There is some evidence to suggest that the APACHE III is a superior prognostic model. 15 However, further larger studies are required to confirm the absolute specificity of this association.…”

Section: Discussionmentioning

confidence: 97%

Vascular endothelial growth factor gene polymorphism and acute respiratory distress syndrome

Medford

2005

Thorax

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Background: Non-cardiogenic pulmonary oedema is a characteristic feature of the acute respiratory distress syndrome (ARDS). The properties of vascular endothelial growth factor (VEGF) as a potent vascular permogen and mitogen have led to investigation of its potential role in this condition. Lower VEGF plasma levels have been linked to the presence of the T allele in the +936 CT polymorphism. We hypothesised that the presence of the T allele would be associated with the development and severity of ARDS. Methods: A cohort of 137 normal subjects, 117 ventilated patients with ARDS, and 103 ''at risk'' of ARDS were genotyped for the VEGF+936 CT polymorphism. The severity of physiological disturbance and mortality was determined in the ventilated cohorts. Results: The CT and TT genotype frequencies were increased in ARDS patients compared with both normal subjects (OR 2.01, 95% CI 1.13 to 3.58, p = 0.02) and those ''at risk'' (OR 2.05, 95% CI 1.02 to 2.20, p = 0.03). In patients with ARDS but not those ''at risk'', CT and TT genotypes were associated with a higher mean APACHE III score (80.9 (4.3) v 69.3 (2.9), p,0.05). Conclusion: These data support a role for VEGF in the pathogenesis of ARDS and its associated physiological derangement.

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Section: Discussionmentioning

confidence: 97%

Vascular endothelial growth factor gene polymorphism and acute respiratory distress syndrome

Medford

2005

Thorax

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“…Their potential and use in clinical management of patients can have significant health, social and economic impact (Beck et al 2003;Lin et al 2007;Lilja et al 2008;Juneja et al 2011). Hence, the search for better, more accurate, and better discriminating models that require only the most certain and measurable of input data is an ongoing task (Beck et al 2003;Rowan et al 2007;Minne et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Assessment of SOFA Score as a Diagnostic Indicator in Intensive Care Medicine

Hewett

Rodgers

Chase

et al. 2012

IFAC Proceedings Volumes

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Abstract:Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is assessed to evaluate its efficacy as a diagnostic indicator. Statistical analyses investigate the SOFA score distributions in the days leading up to patient mortality and patient discharge. It is found that the SOFA score is not an effective predictor of patient mortality, but it is a useful tool for prediction of patient discharge from the Intensive Care Unit (ICU). The distribution of overall SOFA score was observed not to change notably in the days leading up to patient death. However, the SOFA score distribution was observed to have a trend towards lower SOFA scores in the days leading up to patient discharge. Finally, assessment of the individual components of the overall SOFA score indicated that the coagulation and cardiovascular scores showed the highest correlation to mortality and are therefore the most useful individual groups to be used as diagnostic indicators.

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“…Nonetheless, such scores (e.g., SAPS 3 and APACHE III) have been reported to face the same drawbacks as SAPS II [9,12,38]. Moreover, those scores remain the most widely used scores in practice [39].…”

Section: What Are the Next Steps?mentioning

confidence: 99%

“…However, since first being published, they have been modified several times in order to improve their predictive performance [6][7][8][9][10][11]. Despite these extensions of SAPS, predicted hospital mortality remains generally overestimated [8,9,[12][13][14]. As an illustration, Poole et al [9] compared the SAPS II and the SAPS3 performance in a cohort of more than 28,000 admissions to 10 different Italian ICUs.…”

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confidence: 99%

Mortality Prediction in the ICU Based on MIMIC-II Results from the Super ICU Learner Algorithm (SICULA) Project

Pirracchio

2016

Secondary Analysis of Electronic Health Records

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Learning ObjectivesIn this chapter, we illustrate the use of MIMIC II clinical data, non-parametric prediction algorithm, ensemble machine learning, and the Super Learner algorithm. IntroductionPredicting mortality in patients hospitalized in intensive care units (ICU) is crucial for assessing severity of illness and adjudicating the value of novel treatments, interventions and health care policies. Several severity scores have been developed with the objective of predicting hospital mortality from baseline patient characteristics, defined as measurements obtained within the first 24 h after ICU admission. The first scores proposed, APACHE [1] (Acute Physiology and Chronic Health Evaluation), APACHE II [2], and SAPS [3] (Simplified Acute Physiology Score), relied upon subjective methods for variable importance measure, namely by prompting a panel of experts to select and assign weights to variables according to perceived relevance for mortality prediction. Further scores, such as the SAPS II [4] were subsequently developed using statistical modeling techniques [4][5][6][7]. To this day, the SAPS II [4] and APACHE II [2] scores remain the most widely used in clinical practice. However, since first being published, they have been modified several times in order to improve their predictive performance [6][7][8][9][10][11]. Despite these extensions of SAPS, predicted hospital mortality remains generally overestimated [8,9,[12][13][14]. As an illustration, Poole et al. [9] compared the SAPS II and the SAPS3 performance in a cohort of more than 28,000 admissions to 10 different Italian ICUs. They concluded that both scores provided unreliable predictions, but unexpectedly the newer SAPS 3 turned out to overpredict mortality more than the

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External validation of the SAPS II, APACHE II and APACHE III prognostic models in South England: a multicentre study

Cited by 134 publications

References 47 publications

Vascular endothelial growth factor gene polymorphism and acute respiratory distress syndrome

Vascular endothelial growth factor gene polymorphism and acute respiratory distress syndrome

Assessment of SOFA Score as a Diagnostic Indicator in Intensive Care Medicine

Mortality Prediction in the ICU Based on MIMIC-II Results from the Super ICU Learner Algorithm (SICULA) Project

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