The New Simplified Acute Physiology Score (SAPS II) is a revision of the Simplified Acute Physiology Score. It is used to assess patients in the ICU and can predict mortality risk based on the most marked abnormalities of 15 variables.
Comparison with SAPS:
(1) dropped: glucose, hematocrit
(2) added: bilirubin, chronic disease, reason for admission
(3) altered: PaO2/FIO2 (no score if not ventilated or on CPAP)
(4) SAPS II scores range from 0 to 26, vs 0 to 4 in SAPS
Variables |
Scoring Guidelines |
---|---|
age |
age in years at time of last birthday |
heart rate |
use the highest or lowest heart rate in past 24 hours , whichever gives the higher number of points |
systolic blood pressure |
use the highest or lowest blood pressure in past 24 hours , whichever gives the higher number of points |
body temperature |
use highest temperature |
PaO2/FIO2 ratio |
use only if on ventilation or CPAP, using the lowest ratio |
urinary output |
if time period is less than 24 hours, adjust urine output for period to 24 hours |
SUN |
use the highest value |
WBC count |
use the highest or lowest WBC count in past 24 hours , whichever gives the higher number of points |
serum potassium |
use the highest or lowest potassium in past 24 hours , whichever gives the higher number of points |
serum sodium |
use the highest or lowest sodium in past 24 hours , whichever gives the higher number of points |
serum bicarbonate |
use the lowest value |
serum bilirubin |
use the highest value |
Glasgow Coma Score |
use the lowest value; if patient sedated, use the score before sedated |
type of admission |
scheduled surgery if scheduled at least 24 hours prior to operation; unscheduled if operated on with less than 24 hour notice; medical if no surgery within 1 week of admission to ICU |
AIDS |
HIV positive with AIDS defining opportunistic infection or tumor |
hematologic malignancy |
malignant lymphoma, Hodgkin's disease, leukemia or multiple myeloma |
metastatic cancer |
metastases demonstrated at surgery, radiographically or other suitable method |
Variable |
Finding |
Points |
---|---|---|
age in years |
< 40 |
0 |
|
40 - 59 |
7 |
|
60 - 69 |
12 |
|
70 - 74 |
15 |
|
75 - 79 |
16 |
|
>= 80 |
18 |
heart rate in beats per minute |
< 40 |
11 |
|
40 - 69 |
2 |
|
70 - 119 |
0 |
|
120 - 159 |
4 |
|
>= 160 |
7 |
systolic blood pressure in mm Hg |
< 70 |
13 |
|
70 - 99 |
5 |
|
100 - 199 |
0 |
|
>= 200 |
2 |
body temperature in °C |
< 39 °C |
0 |
|
>= 39 |
3 |
if on ventilation or CPAP, PaO2/FIO2 |
< 100 |
11 |
|
100 - 199 |
9 |
|
>= 200 |
6 |
urinary output in L per 24 hours |
< 0.500 |
11 |
|
0.500 - 0.999 |
4 |
|
>= 1.000 |
0 |
serum urea nitrogen in mg/dL |
< 28 |
0 |
|
28 - 83 |
6 |
|
>= 84 |
10 |
WBC count in 1000 per µL |
< 1.0 |
12 |
|
1.0 - 19.9 |
0 |
|
>= 20 |
3 |
serum potassium in mEq/L |
< 3.0 |
3 |
|
3.0 - 4.9 |
0 |
|
>= 5.0 |
3 |
serum sodium in mEq/L |
< 125 |
5 |
|
125 - 144 |
0 |
|
>= 145 |
1 |
serum bicarbonate in mEq/L |
< 15 |
6 |
|
15 - 19 |
3 |
|
>= 20 |
0 |
bilirubin level in mg/dL |
< 4.0 |
0 |
|
4.0 - 5.9 |
4 |
|
>= 6.0 |
9 |
Glasgow Coma score |
< 6 |
26 |
|
6 - 8 |
13 |
|
9 - 10 |
7 |
|
11 - 13 |
5 |
|
14 - 15 |
0 |
chronic diseases |
metastatic carcinoma |
9 |
|
hematologic malignancy |
10 |
|
AIDS |
17 |
type of admission |
scheduled surgery |
0 |
|
medical |
6 |
|
unscheduled surgery |
8 |
SAPS II =
= (points for age) + (points for heart rate) + (points for systolic blood pressure) + (points for body temperature) + (points for ventilation) + (points for urinary output) + (points for SUN) + (points for WBC count) + (points for potassium) + (points for serum) + (points for bicarbonate) + (points for bilirubin) + (points for Glasgow Coma Score) + (points for chronic diseases) + (points for type of admission)
Interpretation
• minimum score 0
• maximum score 160
logit =
= (-7.7631) + (0.0737 * (SAPSII)) + (0.9971 * (LN((SAPSII)+1)))
probability of hospital mortality =
= EXP(logit) / (1 + (EXP(logit)))
Purpose: To use the New Simplified Acute Physiology Score (SAPS II) to assess the risk for death of an ICU patient.
Specialty: Critical Care, Emergency Medicine
Objective: severity, prognosis, stage, differential diagnosis and mimics, red flags, disease progression
ICD-10: R57,