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首页> 外文期刊>Sao Paulo Medical Journal >SAPS 3, APACHE IV or GRACE: which score to choose for acute coronary syndrome patients in intensive care units?
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SAPS 3, APACHE IV or GRACE: which score to choose for acute coronary syndrome patients in intensive care units?

机译：SAPS 3，APACHE IV或GRACE：重症监护病房的急性冠脉综合征患者应选择哪个评分？

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CONTEXT AND OBJECTIVE Acute coronary syndromes (ACS) are a common cause of intensive care unit (ICU) admission. Specific prognostic scores have been developed and validated for ACS patients and, among them, GRACE (Global Registry of Acute Coronary Events) has had the best performance. However, intensive care clinicians generally use prognostic scores developed from heterogeneous populations of critically ill patients, such as APACHE IV (Acute Physiologic and Chronic Health Evaluation IV) and SAPS 3 (Simplified Acute Physiology Score 3). The aim of this study was to evaluate and compare the performance of these three scores in a non-selected population of ACS cases. DESIGN AND SETTING Retrospective observational study to evaluate three prognostic scores in a population of ACS patients admitted to three general ICUs in private hospitals in São Paulo. METHODS All patients with ACS admitted from July 2008 to December 2009 were considered for inclusion in the study. Score calibration and discrimination were evaluated in relation to predicting hospital mortality. RESULTS A total of 1065 patients were included. The calibration was appropriate for APACHE IV and GRACE but not for SAPS 3. The discrimination was very good for all scores (area under curve of 0.862 for GRACE, 0.860 for APACHE IV and 0.804 for SAPS 3). CONCLUSIONS In this population of ACS patients admitted to ICUs, GRACE and APACHE IV were adequately calibrated, but SAPS 3 was not. All three scores had very good discrimination. GRACE and APACHE IV may be used for predicting mortality risk among ACS patients.
机译：上下文和目的急性冠状动脉综合征（ACS）是重症监护病房（ICU）入院的常见原因。已经为ACS患者制定并验证了特定的预后评分，其中GRACE（急性冠脉事件全球注册系统）表现最佳。但是，重症监护临床医生通常使用从重症患者的异质人群中得出的预后评分，例如APACHE IV（急性生理和慢性健康评估IV）和SAPS 3（简化急性生理评分3）。这项研究的目的是评估和比较这三个评分在未选出的ACS病例中的表现。设计与设置回顾性观察性研究旨在评估在圣保罗的私立医院接受三例普通重症监护病房的ACS患者群体的三个预后评分。方法将2008年7月至2009年12月收治的所有ACS患者纳入研究范围。评估分数校准和歧视与预测医院死亡率有关。结果共纳入1065例患者。该校准适用于APACHE IV和GRACE，但不适用于SAPS3。所有分数的区分都非常好（GRACE的曲线下面积为0.862，APACHE IV的曲线下面积为0.860，SAPS 3的曲线下面积为0.804）。结论在接受重症监护病房（ACS）的ACS患者人群中，GRACE和APACHE IV进行了充分校准，而SAPS 3则没有。这三个分数都具有很好的辨别力。 GRACE和APACHE IV可用于预测ACS患者的死亡风险。

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