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    Patent Pending

    Simplified Acute Physiology Score (SAPS) II

    Estimates mortality in ICU patients, comparable to APACHE II.
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    INSTRUCTIONS

    Use the worst values in the past 24 hours.

    When to Use
    Pearls/Pitfalls
    Why Use

    ICU patients.

    • The worst physiological variables, corresponding to the highest number of points, should be collected within the first 24 hours of ICU admission.
    • Superior to the original SAPS system, exhibiting a higher AUROC (0.86) than the original (0.80).
    • Burn and cardiac patients were excluded from the original study, so while there is some evidence suggesting that SAPS II may perform well for these patient groups, this area requires study before SAPS II is used for these patients.
    • Estimates mortality risk for a group of patients, but is not intended to describe an individual patient's chance of survival.

    Can be used to measure quality of care in the ICU (but should not be used to predict survival of an individual).

    <40
    0
    40-59
    +7
    60-69
    +12
    70-74
    +15
    75-79
    +16
    ≥80
    +18
    <40
    +11
    40-69
    +2
    70-119
    0
    120-159
    +4
    ≥160
    +7
    <70
    +13
    70-99
    +5
    100-199
    0
    ≥200
    +2
    No
    0
    Yes
    +3
    14-15
    0
    11-13
    +5
    9-10
    +7
    6-8
    +13
    <6
    +26
    <100 mm Hg/% (13.3 kPa/%)
    +11
    100-199 mm Hg/% (13.3-26.5 kPa/%)
    +9
    ≥200 mm Hg/% (26.6 kPa/%)
    +6
    Not on mechanical ventilation or CPAP within the last 24 hours
    0
    BUN <28 or urea <10
    0
    BUN 28-83 or urea 10-29.6
    +6
    BUN ≥84 or urea ≥30
    +10
    <500
    +11
    500-999
    +4
    ≥1000
    0
    <125
    +5
    125-144
    0
    ≥145
    +1
    <3.0
    +3
    3.0-4.9
    0
    ≥5.0
    +3
    <15
    +6
    15-19
    +3
    ≥20
    0
    <4.0 mg/dL (<68.4 µmol/L)
    0
    4.0-5.9 mg/dL (68.4-102.5 µmol/L)
    +4
    ≥6.0 mg/dL (≥102.6 µmol/L)
    +9
    <1.0
    +12
    1.0-19.9
    0
    ≥20.0
    +3
    None
    0
    Metastatic cancer
    +9
    Hematologic malignancy
    +10
    AIDS
    +17
    Scheduled surgical
    0
    Medical
    +6
    Unscheduled surgical
    +8

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    Scores can be studied within a single ICU setting for quality improvement and other initiatives.

    Formula

    SAPS II Score is calculated by addition of the selected points below.

    In-hospital mortality, % = ex / 1+ex
    where x = −7.7631 + 0.0737 x (SAPS II Score) + 0.9971 x [ ln(SAPS II Score + 1) ]

    SAPS II Score:

    Variable

    Points

    Age, years

     

    <40

    0

    40-59

    7

    60-69

    12

    70-74

    15

    75-79

    16

    ≥80

    18

    Heart rate

    Worst value in 24 hours; if patient has had both cardiac arrest (11 points) and extreme tachycardia (7 points), assign 11 points

    <40

    11

    40-69

    2

    70-119

    0

    120-159

    4

    ≥160

    7

    Systolic BP, mm Hg

    Worst value in 24 hours

    <70

    13

    70-99

    5

    100-199

    0

    ≥200

    2

    Temperature ≥39ºC (102.2ºF)

    Highest temperature in 24 hours

    No

    0

    Yes

    3

    GCS

    Lowest value in 24 hours; if patient is sedated, use estimated GCS before sedation

    14-15

    0

    11-13

    5

    9-10

    7

    6-8

    13

    <6

    26

    PaO₂/FiO₂, if on mechanical ventilation or CPAP

    Lowest value in 24 hours; if patient was extubated <24 hours ago, use lowest value while on mechanical ventilation

    <100 mm Hg/% (13.3 kPa/%)

    11

    100-199 mm Hg/% (13.3-26.5 kPa/%)

    9

    ≥200 mm Hg/% (26.6 kPa/%)

    6

    Not on mechanical ventilation or CPAP within the last 24 hours

    0

    BUN, mg/dL (serum urea, mmol/L)

    Highest value in 24 hours

    BUN <28 or urea <10

    0

    BUN 28-83 or urea 10-29.6

    6

    BUN ≥84 or urea ≥30

    10

    Urine output, mL/day

    If patient in ICU <24 hours, calculate for 24 hours (e.g. if 1 L in 8 hours, then mark 3 L in 24 hours)

    <500

    11

    500-999

    4

    ≥1,000

    0

    Sodium, mEq/L or mmol/L

    Worst value in 24 hours

    <125

    5

    125-144

    0

    ≥145

    1

    Potassium, mEq/L

    Worst value in 24 hours

    <3.0

    3

    3.0-4.9

    0

    ≥5.0

    3

    Bicarbonate, mEq/L

    Lowest value in 24 hours

    <15

    6

    15-19

    3

    ≥20

    0

    Bilirubin

    Highest value in 24 hours

    <4.0 mg/dL (<68.4 µmol/L)

    0

    4.0-5.9 mg/dL (68.4-102.5 µmol/L)

    4

    ≥6.0 mg/dL (≥102.6 µmol/L)

    9

    WBC, x 10³/mm³

     

    Worst value in 24 hours

     

    <1.0

    12

    1.0-19.9

    0

    ≥20.0

    3

    Chronic disease

     

    None

    0

    Metastatic cancer

     9

    Hematologic malignancy

    10

    AIDS

    17

    Type of admission

     

     

    Scheduled surgical = surgery scheduled ≥24 hours in advance

    Medical = no surgery within one week of admission

    Unscheduled surgical = surgery scheduled ≤24 hours in advance

    Scheduled surgical

    0

    Medical

    6

    Unscheduled surgical

    8

    Facts & Figures

    Interpretation:

    In-hospital mortality, % = ex / 1+ex
    where x = −7.7631 + 0.0737 x (SAPS II Score) + 0.9971 x [ ln(SAPS II Score + 1) ]

    Literature

    Dr. Jean-Roger Le Gall

    About the Creator

    Jean-Roger Le Gall, MD, served for 20 years as professor and head of the intensive care unit of the Saint-Louis University Hospital in Paris, France. His research interests include prognostic measures in intensive care, sepsis, and measures of performance of intensive care units. Dr. Le Gall has authored several peer-reviewed studies in critical care medicine.

    To view Dr. Jean-Roger Le Gall's publications, visit PubMed

    About the Creator
    Dr. Jean-Roger Le Gall