Outcomes Prediction in Critically Ill Elderly Patients Using MPM0-III and SAPS 3 scores.

Document Type : Original Article

Authors

Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University

Abstract

Background:
As the global population ages, the demand for accurate prognostic tools for this vulnerable demographic has intensified.
Objective:
Evaluating the prognostic ability of the Mortality Prediction Model (MPM0-III) and Simplified Acute Physiologic Score (SAPS 3) scoring systems in severely ill elderly patients admitted to Geriatrics ICU at Ahmed Shawki Hospital, Ain Shams University Hospitals.
Methods:
A 6-month prospective observational cohort research included 106 old patients of both sexes admitted to the Geriatrics ICU at Ahmed Shawki Hospital, Ain Shams University Hospitals. The following information was recorded: demographics, history, physical examination, vital signs, conscious level assessment, worst parameters of clinical and laboratory data needed to determine the severity of illness, and survival status (death or release from the ICU). This information was collected both at the time of admission and during the first 72 hours of the patient's stay in the hospital. RNSH-ICU calculators were used to formulate the Mortality Probability Model Score at 24, 48, and 72 hours after admission. MDCalc was used to calculate the Simplified Acute Physiology Score 3 on admission.
Results:
Comparison between survivors and non-survivors as regards MPM0-III and SAPS 3 predictive mortality rates revealed a statistically significant higher score (in both) among the non-survivors (P<0.001). MPM24 had the best calibration while MPM72 showed the best AUC. When the odds of mortality were estimated utilising MPM0-III and SAPS 3 scores by logistic regression analysis, both were found highly significant (P<0.001).
Conclusion:
With an acceptable degree of discrimination and calibration, the two severity of illness scoring systems (MPM0-III and SAPS 3) performed well and can be used to predict death in elderly critically ill patients.

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