Mortality probability model III and simplified acute physiology score II: assessing their value in predicting length of stay and comparison to APACHE IV.

Abstract:

BACKGROUND:To develop and compare ICU length-of-stay (LOS) risk-adjustment models using three commonly used mortality or LOS prediction models. METHODS:Between 2001 and 2004, we performed a retrospective, observational study of 11,295 ICU patients from 35 hospitals in the California Intensive Care Outcomes Project. We compared the accuracy of the following three LOS models: a recalibrated acute physiology and chronic health evaluation (APACHE) IV-LOS model; and models developed using risk factors in the mortality probability model III at zero hours (MPM(0)) and the simplified acute physiology score (SAPS) II mortality prediction model. We evaluated models by calculating the following: (1) grouped coefficients of determination; (2) differences between observed and predicted LOS across subgroups; and (3) intraclass correlations of observed/expected LOS ratios between models. RESULTS:The grouped coefficients of determination were APACHE IV with coefficients recalibrated to the LOS values of the study cohort (APACHE IVrecal) [R(2) = 0.422], mortality probability model III at zero hours (MPM(0) III) [R(2) = 0.279], and simplified acute physiology score (SAPS II) [R(2) = 0.008]. For each decile of predicted ICU LOS, the mean predicted LOS vs the observed LOS was significantly different (p

journal_name

Chest

journal_title

Chest

authors

Vasilevskis EE,Kuzniewicz MW,Cason BA,Lane RK,Dean ML,Clay T,Rennie DJ,Vittinghoff E,Dudley RA

doi

10.1378/chest.08-2591

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

89-101

issue

1

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(09)60409-8

journal_volume

136

pub_type

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