Korean J Crit Care Med.  2009 Apr;24(1):4-10. 10.4266/kjccm.2009.24.1.4.

The Prognostic Utility of the Simplified Acute Physiology Score II (SAPS II) and the Sequential Organ Failure Assessment (SOFA) Score for Hemato-Oncology Patients Admitted to the Intensive Care Unit

• Park S
• Koh WJ
• Chung MP
• Kim H
• Kwon OJ
• Kang WK
• Jung CW
• Ahn JS
• Suh GY

• KMID: 2228360
• DOI: http://doi.org/10.4266/kjccm.2009.24.1.4

Abstract

BACKGROUND: The prognosis of hemato-oncology (HMO) patients admitted to the intensive care unit (ICU) is poor and predicting the mortality is important for decision making at the time of ICU admission and for administering aggressive treatment.
METHODS
We retrospectively reviewed 309 patients who were admitted to the medical ICU (MICU) at Samsung Medical Center from July in 2005 to June in 2006. We calculated their Simplified Acute Physiology Score II (SAPS II) and the Sequential Organ Failure Assessment (SOFA) score at the time of ICU admission and we investigated the relationship between the two scoring systems and the hospital mortality.
RESULTS
Among the 309 patients, the hospital mortality was 41.2%, and the mean SAPS II/SOFA score at ICU admission was 45.4 +/- 19.5/8.1 +/- 4.6. Seventy-nine (25.6%) patients had hemato-oncological diseases. Their hospital mortality was 65.8%, and the mean SAPS II/SOFA score at the time of ICU admission was 53.9 +/- 18.6/9.7 +/- 4.4, which was higher than that of the non-HMO patients (p = 0.00). The area under the receiver operating characteristic (ROC) curves for the SAPS II/SOFA score for predicting the mortality was 0.794 +/- 0.05/0.785 +/- 0.051 (p = 0.00/p = 0.00) for the HMO patients. There was no significant difference in discrimination ability between the two scoring systems (p > 0.05). None of the HMO patients with a SAPS II/SOFA score of 70/14 or higher survived.
CONCLUSIONS
Both the SAPS II and SOFA scores at the time of ICU admission were similarly effective for predicting the hospital mortality. The two scoring systems could be useful tools for decision making at the time of ICU admission and for administering aggressive treatment.

Keyword

hematology; intensive care unit; oncology; prognosis; sequential organ failure assessment; simplified acute physiology score II

MeSH Terms

Decision Making
Discrimination (Psychology)
Health Maintenance Organizations
Hematology
Hospital Mortality
Humans
Critical Care
Intensive Care Units
Prognosis
Retrospective Studies
ROC Curve