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  • Poster presentation
  • Open Access

ICU scoring systems: which one to use in oncology patients?

  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care201115 (Suppl 1) :P503

https://doi.org/10.1186/cc9923

  • Published:

Keywords

  • Primary Outcome
  • Mechanical Ventilation
  • Baseline Characteristic
  • Emergency Medicine
  • Good Accuracy

Introduction

The aim was to assess the performance of various ICU scoring systems in oncology patients.

Methods

A prospective analysis of data for all oncology patients admitted to the ICU over 6 months. For mortality prediction, SMR was computed. Calibration was assessed by Lemeshow-Hosmer goodness-of-fit test and discrimination by AUROC curves. Primary outcome was ICU mortality.

Results

ICU mortality was 36.5%. Mortality predicted by SAPS II score was closest to that of actual mortality with a SMR of 1.003, followed by that of MPM II0 (0.855) and APACHE II (1.181) scores (Table 1). SAPS II (X2 = 1.842; P = 0.985) had the best calibration. Mechanical ventilation and use of vasopressors were significant baseline characteristics (Table 1). All of the scores tested had good efficacy but none reached statistical significance (Table 2).
Table 1

(abstract P503). AUC for predicting ICU mortality

Parameter

Survivors

Nonsurvivors

P value

Males

44

26

0.854

Females

22

12

 

Metastasis

42

22

0.562

Ventilation

5

35

0.00

Vasopressors

7

37

0.00

Table 2

Baseline characteristics of survivors and nonsurvivors

Scoring system

AUC

95% CI

APACHE II

0.726

0.629 to 0.824

APACHE III

0.818

0.733 to 0.903

APACHE IV

0.793

0.707 to 0.880

SAPS II

0.718

0.615 to 0.820

SAPS III

0.781

0.686 to 0.877

MPM II0

0.750

0.648 to 0.853

MPM III0

0.684

0.573 to 0.795

SOFA

0.769

0.678 to 0.859

Conclusions

The SAPS II and APACHE III scores showed good accuracy, calibration and mortality prediction. Nevertheless, the difference in efficacy was not statistically significant and the choice of scoring system may depend on the ease of use and local preferences.

Authors’ Affiliations

(1)
Max Superspeciality Hospital, Delhi, India

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