1. Customization and external validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) in Brazilian critically ill patients.
- Author
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Zampieri FG, Granholm A, Møller MH, Scotti AV, Alves A, Cabral MM, Sousa MF, Balieiro HM, Hortala CC Jr, Filho EMR, Perecmanis E, de Magalhães Menezes MA, Moreira CEN, Moralez GM, Bafi AT, de Carvalho CB, Salluh JIF, Bozza FA, Perner A, and Soares M
- Subjects
- Adult, Aged, Aged, 80 and over, Brazil, Calibration, Cohort Studies, Critical Illness mortality, Female, Hospitalization, Humans, Male, Middle Aged, Severity of Illness Index, Simplified Acute Physiology Score, Hospital Mortality, Intensive Care Units statistics & numerical data
- Abstract
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., Competing Interests: Declaration of Competing Interest MS and JIFS are proprietary and founder of Epimed Solutions®, a cloud-based registry for intensive care units that was used for the ORCHESTRA database. AG, AP, and MHM were involved in the development of the SMS-ICU. The ICU, Rigshospitalet receives fund for other research projects from Ferring Pharmaceuticals, Denmark, and the Novo Nordisk Foundation, Denmark., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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