Dados do Trabalho

Título

Decoding ICU Outcomes: A Battle of Prognostic Titans—Simplified Acute Physiology Score 3 (SAPS3) vs. Estimated Probability of Mortality (EPM)

Objetivo

This study aimed to evaluate the prognostic accuracy of the SAPS3 and EPM scores in predicting mortality and length of stay in critically ill patients admitted to a private ICU.

Métodos

A cohort study was conducted on patients aged over 18 years, admitted to a private ICU in João Pessoa, Brazil, in 2023. SAPS3 and EPM scores were calculated upon admission. Mortality and prolonged ICU stay (defined as >5 days) were the primary outcomes.

Resultados

A total of 2337 patients were included, with a median age of 71 years. The median SAPS3 score was 48, and the median EPM score was 5.54. Of these patients, 231 (9.9%) died during their ICU stay. Those who died had significantly higher SAPS3 (70 vs. 47, p<0.001) and EPM scores (41.11 vs. 4.55, p<0.001). Multivariate regression analysis confirmed that higher SAPS3 (OR 1.056, p<0.001) and EPM (OR 1.036, p<0.001) scores were independently associated with increased mortality risk. The AUROC for SAPS3 in predicting mortality was 0.868, while for EPM, it was 0.894. Additionally, 695 patients (29.7%) had prolonged ICU stays, which were also associated with elevated SAPS3 (OR 1.052, p<0.001) and EPM scores (OR 1.006, p=0.1). The AUROCs for predicting prolonged ICU stay were 0.737 for SAPS3 and 0.749 for EPM.

Conclusão

Both SAPS3 and EPM scores are strong predictors of mortality and prolonged ICU stay in critically ill patients. Their integration into clinical practice could enhance patient stratification and resource allocation, ultimately improving ICU outcomes.