New Simplified Acute Physiology Score | Medical Algorithm

Description

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)))

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Description

Specialty

Objective

ICD-10

New Simplified Acute Physiology Score (SAPS II)

Purpose: To use the New Simplified Acute Physiology Score (SAPS II) to assess the risk for death of an ICU patient.

Description

Specialty

Objective

ICD-10