SAPS 3

Overview

SAPS 3 is organised into three boxes collecting information available at the time of ICU admission. The total score ranges from 0 to 217 points, which is converted to a predicted in-hospital mortality probability via a logistic regression equation. Unlike APACHE II, SAPS 3 offers seven region-specific equations to correct for international differences in case mix and hospital structure.

Box I — Patient Information

Variable	Category	Points
Age	< 40 years	0
	40–59 years	5
	60–69 years	9
	70–74 years	13
	75–79 years	15
	≥ 80 years	18
CHF (NYHA IV)	Present	6
Cirrhosis	Present	4
Alcohol abuse	Present	3
Solid tumour	Present	6
Haematological malignancy	Present	6
Metastatic cancer	Present	9
AIDS	Present	8

Box II — Admission Circumstances

Variable	Category	Points
Pre-ICU location	Recovery / post-op	−6
	Emergency room	0
	Other hospital	0
	Hospital ward	6
	Direct admission	0
Surgical admission	Yes	+1 (modifier)
Reason for ICU	Sepsis	5
	Respiratory failure	4
	Cardiac arrest	10
	Cardiac rhythm disorder	5
	Trauma	−8
	Intoxication / overdose	−13
	Intracranial mass effect	7
	Elective surgery	−6

Box III — Acute Physiology

Variable	Category	Points
GCS	15	0
	13–14	4
	10–12	7
	7–9	10
	3–6	15
Bilirubin (mg/dL)	< 2	0
	2–5.9	4
	6–8.9	5
	≥ 9	6
Temperature (°C)	< 35	4
	35–39.9	0
	≥ 40	3
Heart rate (bpm)	< 40	11
	40–59	2
	60–119	0
	120–159	4
	≥ 160	7
MAP (mmHg)	< 40	18
	40–69	7
	70–119	0
	≥ 120	3
Creatinine (mg/dL)	< 1.2	0
	1.2–1.99	2
	2.0–3.49	7
	≥ 3.5	8
Platelets (×10³/µL)	< 20	13
	20–49	8
	50–99	5
	100–149	3
	≥ 150	0
WBC (×10³/µL)	< 1	12
	1–14.9	0
	≥ 15	3
Arterial pH	< 7.00	14
	7.00–7.24	11
	7.25–7.32	6
	7.33–7.49	0
	≥ 7.50	3
PaO₂/FiO₂ (mmHg)	< 100	11
	100–199	9
	≥ 200	5

Mortality Formula

logit = −32.6659 + ln(SAPS 3 score + 1) × 7.3068

Predicted mortality = e^logit / (1 + e^logit)

Seven region-specific equations (Europe, Americas, etc.) are available for improved local calibration.

Risk Classification

Predicted Mortality	Risk Class
< 10 %	Low
10–25 %	Moderate
25–50 %	High
> 50 %	Very high

Literature

Moreno RP, Metnitz PG, Almeida E, et al. SAPS 3 — From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description. Intensive Care Med. 2005;31(10):1336–1344.

Metnitz PG, Moreno RP, Almeida E, et al. SAPS 3 — From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med. 2005;31(10):1345–1355.