Background & Aims: Different scoring systems are used in order to assess the functional quality of intensive care units (ICU) and to predict the required costs and facilities of intensive cares. Variety of scoring systems has been explained that each has advantages and disadvantages. In this study Simplified Acute Physiology Score-III (SAPS-III) and Mortality Probability Model-III (MPM-III) were compared. Materials & Methods: The current cross-sectional study was conducted on 240 non-traumatic patients admitted at ICU of Al-Zahra Hospital in 2016-17. Patients' information including demographics, mean of systolic, diastolic and arterial pressure, pulse rate, respiratory rate, temperature, Glasgow Coma Scale(GCS), WBC, hematocrit, bilirubin, creatinine, arterial blood gas, and the presence of underlying diseases was gathered from the records for measurement of MPM-III and SAPS-III scores and then they were compared. Results: This study was conducted on 240 non-traumatic patients. Discrimination of MPM-III in cutoff point of 0. 17 was 0. 83(P<0. 001; 95%CI: 0. 765-0. 898), sensitivity and specificity of this test in prediction of non-traumatic mortality was 82% and 73%, respectively. Discrimination of SAPS-III in cut-off of 48. 5 was 0. 78(P<0. 001; 95%CI: 0. 72-0. 84), while its sensitivity and specificity was 83% and 70%, respectively. Duration of ICU hospitalization (P=0. 028 and 0. 002) and duration of intubation (P=0. 001 and <0. 001) had direct association with mortality based on both scoring systems while total duration of hospitalization was only significant in SAPSIII (P=0. 002). Conclusion: Comparison of SAPS-III and MPM-III in non-traumatic patients presented a higher discrimination ability for MPM-III. In addition, findings showed that mortality in MPM-III was in association with duration of ICU admission and intubation while for SAPS-III, in addition to previous factors, total duration of hospitalization was associated as well.

Background: Intensive care unit (ICU) is among the most important hospital wards. Variety of scoring systems for evaluation of patients' status and prediction of hospitalization outcomes in ICU has been raised that each has strong and weak points; assessment of these characteristics tends to promote new scoring systems. The current study compared scoring systems of Mortality Probability Model-III (MPM-III) and Simplified Acute Physiology Score-III (SAPS-III) in trauma patients in ICU. Methods: This randomized cross-sectional study was conducted on 200 patients admitted in ICU because of trauma in years 2016-17. Patients' information including demographics, mean of systolic, diastolic, and arterial blood pressure, pulse, respiratory rate, temperature, Glasgow coma scale (GCS), arterial gas analysis, white blood cell (WBC) counts, hematocrit, bilirubin, creatinine, type of admission, and presence of underlying diseases were extracted from records; MPM-III and SAPS-III were measured for these patients and compared. Findings: MPM-III scoring system had discrimination of 0. 935 [95% confidence interval (95%CI): 0. 89-0. 97; P < 0. 001) in cut-off point of 0. 13, and its sensitivity and specificity was 87% and 84%, respectively. For SAPS-III system, in cut-off point of 0. 13, the discrimination was 0. 77 (95%CI: 0. 69-0. 85; P < 0. 001), with the sensitivity of 80% and specificity of 68%. Based on both MPM-III and SAPS-III systems, mortality was in correlation with duration of ICU admission (P = 0. 001 for both systems) and duration of intubation (P < 0. 001 for both systems), while only for SAPS-III, total duration of hospitalization was in correlation with mortality (P < 0. 001). Conclusion: MPM-III scoring system was superior to SAPS-III regarding discrimination power in trauma patients. In addition, based on both systems, mortality rate was in direct association with days of ICU admission and intubation duration.

Background: Scoring systems have been developed to predict outcomes in the critical patients and to facilitate the decision making and resource allocation for management of such patients.Objective: The aim of this study was to compare Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in predicting hospital mortality of intensive care unit patients.Methods: This cross-sectional study was conducted on 88 patients admitted to the intensive care unit because of trauma or surgery in Shahid Rajaee hospital, Qazvin 2008. During the first 24 hours of admission, the results of clinical examination and biochemical assays and demographic information were collected to complete each of the scoring systems. Observed mortality and predicted mortality were recorded and compared. Detection value of scoring systems was assessed by Receiver Operating Characteristic (ROC) curves and data were analyzed using logistic regression analysis and Chi-Square test.Findings: Mean age of patients was 44.25±23.09 years (2 to 86 years). Observed mortality in ICU was 32.5% and predicted mortalities were 23.63±24.2% and 19.88±15.1% according to SAPS II and APACHE II, respectively. There was positive significant correlation between SAPS II and APACHE II scoring systems and between these two scoring systems and observed mortality. There was also positive significant correlation between SAPS II and APACHE II values and GCS score. Area under the ROC curve (AUC) of APACHE II was greater than SAPS II for predicting observed mortality (0.823 vs. 0.790).Conclusion: With regards to the results, both APACHE II and SAPS II scoring systems can be used to predict mortality of intensive care unit patients, but not to help in definite decision-making.

This study aimed to assess the severity of poisoning, various scoring systems, including Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and chronic health evaluation II (APACHE II), Simplified Acute Physiology Score (SAPS II), Modified APACHE II, and poisoning severity score (PSS) were used. In this study, we compared the predictive value of these scoring systems on the outcome of pesticide-poisoned patients. Methods: This is a cross-sectional study of pesticide-poisoned patients (140 patients) who were admitted to the intensive care unit (ICU) of Khorshid Hospital, Isfahan, Iran, between January 2015 and 2019. The area under the receiver operating characteristic (AUC) curve and the predictive value of scoring systems were compared. Findings: Poisoning was higher in the male population (72.8%). The causes of poisoning were paraquat, (38.6%), aluminum phosphide, (32.1%), and organophosphate, (29.3%). The mean age of the patients was 33.9 years. Most patients (79.3%) attempted suicide. The mortality rate was 46.43%. The mean of “SOFA score,” “APACHE II,” “SAPS II,” “Modified APACHE II,” and “PSS” was 5.9; 15.7; 30.02; 15.8; and 1.9, respectively. There was a significant difference in the mean of all scoring systems for outcome prediction. Among all scoring systems, the SAPS II score with the cutoff point (16.5) had the best criteria for outcome prediction (AUC (0.831 ± 0.037), sensitivity (83.1%, 95% confidence interval [CI]: [71.7–91.2]), specificity (75.7%, 95% CI: [64.3–84.9]), positive predictive values (75.0%, 95% CI: [66.4–82.0]), negative predictive values (83.6%, 95% CI: [74.5–89.9]). Conclusion: The SAPS II scoring system may be a suitable indicator for outcome predictions in pesticide-poisoned patients in the ICU.

Background: This study aimed to assess the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiologic Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) scores in predicting mortality rate in poisoning patients admitted to an intensive care unit (ICU). Methods: This cross-sectional study was performed on all admitted patients in the poisoning ICU of Imam Reza Hospital, Mashhad City, Iran. All patients were evaluated for three consecutive days since admission time and then every two days until discharge from ICU or death. The scoring systems mentioned above were calculated and analyzed by MedCalc statistical software version 18. 9. 1 and SPSS version 16. Results: Overall, 150 patients were studied, out of whom 67% (101) were male. Their mean± SD age was 41. 6± 18. 9 years. In their whole hospitalization period, APACHE II (79. 5%), SAPS II (78. 7%), APACHE IV (78. 4%), and SOFA (72. 9%) were the most precise measures. On the first day of admission APACHE II (77. 4%), on the second day, APACHE II (83. 1%), on the third day, APACHE II (90. 7%), and on the fifth day, SOFA (81. 6%) were the most precise measures. Conclusion: All four systems have acceptable discriminatory power for poisoned patients. However, it seems that APACHE II can be used for mortality prediction, especially in the early days of admission.

Background: Opioid poisoning is the most common type of poisoning in intensive care units (ICUs). This group usually includes patients who have been drug abusers for a long time and now require hospitalization either because of Acute overdose or due to side effects of routine opioid use. This study aimed to compare the severity and prognosis of patients using common mortality predictors Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score (SAPS II), Acute Physiology And Chronic Health Evaluation (APACHE II, APACHE IV) on different days of hospitalization. Methods: This cross-sectional study was performed on all patients with opioid poisoning admitted to the ICU, Imam Reza Hospital, Mashhad, Iran, from the beginning of April 2016 to March 2017 (Persian Calendar). For all poisoned patients enrolled in the study, the four mortality predicting tools were filled daily in the first three days of hospitalization and then every other day until discharge from the ICU or patient's death. Results: Overall, 57 patients were evaluated of whom 72% (41 patients) were male. The mean age was 49. 9± 19. 8 (median 53, range 18-94) years. The mean length of stay in the ICU was 13. 5± 17. 5 (median 7, range: 75-75) days. The mortality rate was 17. 5% (10 patients). The scores of SOFA, SAPS II, APACHE II, and APACHE IV were significantly higher in deceased patients than in discharged ones. The highest diagnostic accuracy (area under the curve) for all four predicting tools was observed in the second week of hospitalization. On the other hand, SAPS II (74%) on the first day, APACHEII (76%) on the second day, APACHE-II (82%) on the third day, SOFA (77%) on day 4-5, and SAPS II (82%) on day 6-7 had the highest diagnostic accuracy. Conclusion: In the present study scores of all four mortality predicting tools at admission were significantly associated with mortality. The accuracy of SAPS II, APACHE IV, and APACHE II are appropriate for estimating prognosis, especially after the second week of admission.

Background: There are different scoring systems to determine the mortality rate of patients to intensive care unit (ICU), the aim of this study was to compare the Simplified Acute Physiology Score (SAPS) III and Sequential Organ Failure Assessment (SOFA) tests in determining the degree of mortality in non-traumatic patients who admitted to the intensive care unit (ICU). Methods: In this retrospective cross-sectional study, mortality rate was assessed with using of SOFA and SAPS III scorings on 100 non traumatic patients who admitted to the ICU according to the inclusion and exclusion criteria. The patients were also divided into two groups based on mortality and were included survive and non-survive groups. Results: The mean SOFA score in survived and non-survived groups were 2. 03 + 1. 96 and 5. 42 + 3. 84 respectively, and for SAPS III, were 30. 76 + 8. 17 and 55. 38 + 15. 47 respectively. The SOFA and SAPS III scores in the non-survived group was significantly higher than survived group (P <0. 0001 for both tests). The sensitivities, specificities, positive predictive value and negative predictive value were 79/75%, 85/71%, 95/5%, 52/9% for the SAPSII score, respectively and 91/14%, 57/14%, 88/9%, 63/2% for the SOFA Scoring system, respectively. Conclusion: SAPS III was a better prognostic score in determining of mortality.

Background: The aim of this study is to compare the performance of five applied general severity scoring systems and their ability to predict mortality rate for the intensive care unit patients: Simplified Acute Physiology Score II (SAPS II), Mortality Probability Model II at admission (MPM II0), at 24 hours (MPM II24), at 48 hours (MPM II48) and over time (MPM IIovertime). These scoring systems have been developed in response to an increased emphasis on the evaluation and monitoring of health care services; and also making cost-effective decisions.Materials and Methods: In this historical cohort study, all of the scoring systems were applied to 114 patients and the predicted mortality rate and the Standardized Mortality Ratio (SMR) were calculated for them.Calibration of each model and discriminative powers were evaluated by using Hosmer-Lemeshow goodness of fit test and ROC curve analysis, respectively.Results: The predicted mortalities were not significantly deviated from the main systems (SMR for SAPS II: 0.79, MPM II0: 1.10, MPM II24: 1.32, MPM II48: 1.08 and MPMOvertime: 1.02). The Hosmer-Lemeshow statistics had the least value for MPM II48 (C=2.922, p-value=0.939); and the discrimination was best for MPM II24 (AUC=0.927) followed by SAPS II (AUC=0.903), MPM II0 (AUC=0.899), MPM II48 (AUC=0.848) and MPMIIovertime(AUC=0.861). Conclusion: All five general ICU morality predictors showed accurate standardized mortality ratio. MPM II24 had the best discrimination, MPM II0 had the best SMR before 24 hours and MPMovertime had the best SMR after 24 hours. Performance of MPM II and its ease of use make it an efficient model for mortality prediction in our study.