SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description

OBJECTIVE: Risk adjustment systems now in use were developed more than a decade ago and lack prognostic performance. Objective of the SAPS 3 study was to collect data about risk factors and outcomes in a heterogeneous cohort of intensive care unit (ICU) patients, in order to develop a new, improved model for risk adjustment. DESIGN: Prospective multicentre, multinational cohort study. PATIENTS AND SETTING: A total of 19,577 patients consecutively admitted to 307 ICUs from 14 October to 15 December 2002. MEASUREMENTS AND RESULTS: Data were collected at ICU admission, on days 1, 2 and 3, and the last day of the ICU stay. Data included sociodemographics, chronic conditions, diagnostic information, physiological derangement at ICU admission, number and severity of organ dysfunctions, length of ICU and hospital stay, and vital status at ICU and hospital discharge. Data reliability was tested with use of kappa statistics and intraclass-correlation coefficients, which were >0.85 for the majority of variables. Completeness of the data was also satisfactory, with 1 [0–3] SAPS II parameter missing per patient. Prognostic performance of the SAPS II was poor, with significant differences between observed and expected mortality rates for the overall cohort and four (of seven) defined regions, and poor calibration for most tested subgroups. CONCLUSIONS: The SAPS 3 study was able to provide a high-quality multinational database, reflecting heterogeneity of current ICU case-mix and typology. The poor performance of SAPS II in this cohort underscores the need for development of a new risk adjustment system for critically ill patients. ELECTRONIC SUPPLEMENTARY MATERIAL: Electronic supplementary material is included in the online fulltext version of this article and accessible for authorised users: http://dx.doi.org/10.1007/s00134-005-2762-

A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study.

OBJECTIVE: To develop and validate a new Simplified Acute Physiology Score, the SAPS II, from a large sample of surgical and medical patients, and to provide a method to convert the score to a probability of hospital mortality. DESIGN AND SETTING: The SAPS II and the probability of hospital mortality were developed and validated using data from consecutive admissions to 137 adult medical and/or surgical intensive care units in 12 countries. PATIENTS: The 13,152 patients were randomly divided into developmental (65%) and validation (35%) samples. Patients younger than 18 years, burn patients, coronary care patients, and cardiac surgery patients were excluded. OUTCOME MEASURE: Vital status at hospital discharge. RESULTS: The SAPS II includes only 17 variables: 12 physiology variables, age, type of admission (scheduled surgical, unscheduled surgical, or medical), and three underlying disease variables (acquired immunodeficiency syndrome, metastatic cancer, and hematologic malignancy). Goodness-of-fit tests indicated that the model performed well in the developmental sample and validated well in an independent sample of patients (P = .883 and P = .104 in the developmental and validation samples, respectively). The area under the receiver operating characteristic curve was 0.88 in the developmental sample and 0.86 in the validation sample. CONCLUSION: The SAPS II, based on a large international sample of patients, provides an estimate of the risk of death without having to specify a primary diagnosis. This is a starting point for future evaluation of the efficiency of intensive care units

An evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence in Acutely ill Patients (SOAP) study

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Sepsis in European intensive care units: Results of the SOAP study

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Adapter le piégeage lumineux pour collecter la faune domiciliaire dans le centre du Cameroun : une étude-pilote

International audienceVarious trapping methods and techniques developed for entomological studies are inefficient in attracting all arthropod groups. A new simple light trap, the basin light trap (BLT), to collect arthropod fauna around household in central Cameroon was thus designed. Its performance is evaluated by comparing collected data with those obtained by the Centre for Disease Control light trap (CDC) commonly used in mosquito studies. BLT were activated between 6 and 10 pm and CDC between 5 pm and 8 am. A total of 36,804 arthropods specimens were collected and sorted into 115 families within 20 orders and three phyla (Myriapoda, Arachnida and Hexapoda). BLT attracted more individuals (22,250 vs 14,554), families (106 vs 65) and significantly more families per night (33.0 ± 15.9 vs 21.0 ± 8.5) than CDC. Some families were collected by only one specific trap type while others overlapped between the two traps. Prosopistomatidae (Ephemeroptera) was the most abundant family collected by BLT. In contrast, Cecidomyiidae (Diptera) was the most abundant taxon trapped by CDC. These results indicate that collecting methods such as BLT complement available trapping methods in evaluating arthropod fauna in and around households.De nombreuses méthodes et techniques de piégeage développées et utilisées pour les études entomologiques ne sont pas assez efficaces pour collecter tous les groupes d’arthropodes. À cet effet, il a été développé un nouveau type de piège lumineux appelé piège lumineux à bassine (PLB) servant à récolter la faune d’arthropodes autour des maisons dans la région du Centre au Cameroun. Son efficacité a été évaluée en comparant les données recueillies avec celles du piège lumineux développé par le Center for Disease Control (CDC) couramment utilisé dans l’échantillonnage des moustiques. Les PLB ont été installés entre 18 et 22 h et les pièges CDC entre 17 h et 8 h. Un total de 36,804 individus ont été collectés et triés en 115 familles réparties dans 20 ordres des classes suivantes : Myriapoda, Arachnida et Hexapoda. Les PLB ont attiré plus d’individus (22,250 vs 14,554), plus de familles (106 vs 65) et plus de familles par nuit (33,0 ± 15,9 vs 21,0 ± 8,5) par rapport aux CDC. Certaines familles ont été collectées uniquement dans un seul type de piège, pendant que d’autres ont été capturées dans les deux types de pièges. Les Prosopistomatidae (Ephemeroptera) étaient la famille la plus abondante dans le PLB, tandis que les Cecidomyiidae (Diptera) étaient la famille la plus abondante dans les pièges CDC. Ces résultats attestent que d’autres méthodes de collecte telles que les PLB peuvent être utilisées pour compléter les données des pièges lumineux CDC et d’autres méthodes de piégeage dans les études de la faune d’arthropodes domiciliaires