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  SAPS II: Simplified Acute Physiology Score II

 
Input
 
Age  
Heart rate  
Systolic blood pressure  
Temperature  
On ventilator or BiPAP within 24 hours No (0)

Yes (1)
PaO2/FIO2  
Urine output  
Serum BUN  
White blood cell count  
Serum potassium  
Serum sodium  
Serum bicarbonate  
Serum bilirubin  
Glasgow coma score  
Chronic diseases No (0)

Metastatic cancer (9)

Hematologic malignancy (10)

AIDS (17)
Admission type Scheduled surgery (0)

Medical (6)

Unscheduled surgery (8)

 
Results
 
 
SAPS II Score  
Logit  
Hospital Mortality Probability  
 

 
     
 
Include literature references: Yes   No
 
Notes
  • For the SAPS 2 score to be correct, a value must be selected for every variable.

 
Equations used
 
SAPS II Score = AgeFactor + TemperatureFactor + Systolic blood pressureFactor + Heart rateFactor + (On ventilator or BiPAP within 24 hours * PaO2/FIO2Factor ) + Urine outputFactor + Serum bicarbonateFactor + Serum bilirubinFactor + Serum sodiumFactor + Serum potassiumFactor + Serum BUNFactor + Glasgow coma scoreFactor + White blood cell countFactor + Chronic diseases + Admission type
Logit = (0.0737 * SAPS II Score)+ (0.9971 * ln(SAPS II Score + 1)) -7.7631
Hospital Mortality Probability = 100 * e(Logit) / (1 + e(Logit))

 

 
Calculation Details and Variables
  • AgeFactor is assigned values by this ordered logic:
    • If Age <40 yr AgeFactor = 0
    • Else if Age <60 yr AgeFactor = 7
    • Else if Age <70 yr AgeFactor = 12
    • Else if Age <75 yr AgeFactor = 15
    • Else if Age <80 yr AgeFactor = 16
    • Else AgeFactor = 18.
  • HRFactor is assigned values by this ordered logic:
    • If Heart rate ≥160 beats/min HRFactor = 7
    • Else if Heart rate ≥120 beats/min HRFactor = 4
    • Else if Heart rate ≥70 beats/min HRFactor = 0
    • Else if Heart rate ≥40 beats/min HRFactor = 2
    • Else HRFactor = 11.
  • SBPFactor is assigned values by this ordered logic:
    • If Systolic blood pressure ≥200 mmHg SBPFactor = 2
    • Else if Systolic blood pressure ≥100 mmHg SBPFactor = 0
    • Else if Systolic blood pressure ≥70 mmHg SBPFactor = 5
    • Else SBPFactor = 13.
  • TempFactor is assigned values by this ordered logic:
    • If Temperature ≥39 degC TempFactor = 3
    • Else TempFactor = 0.
  • Equation parameters such as On ventilator or BiPAP within 24 hours, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (0), represent the values that will be used.
  • pafiFactor is assigned values by this ordered logic:
    • If PaO2/FIO2 ≥200 mmHg/FIO2 pafiFactor = 6
    • Else if PaO2/FIO2 ≥100 mmHg/FIO2 pafiFactor = 9
    • Else pafiFactor = 11.
  • UOFactor is assigned values by this ordered logic:
    • If Urine output ≥1000 mL/day UOFactor = 0
    • Else if Urine output ≥500 mL/day UOFactor = 4
    • Else UOFactor = 11.
  • BUNFactor is assigned values by this ordered logic:
    • If Serum BUN ≥84 mg/dL BUNFactor = 10
    • Else if Serum BUN ≥28 mg/dL BUNFactor = 6
    • Else BUNFactor = 0.
  • WBCFactor is assigned values by this ordered logic:
    • If White blood cell count ≥20 x10(3)/mcL WBCFactor = 3
    • Else if White blood cell count ≥1 x10(3)/mcL WBCFactor = 0
    • Else WBCFactor = 12.
  • KFactor is assigned values by this ordered logic:
    • If Serum potassium ≥5 mmol/L KFactor = 3
    • Else if Serum potassium ≥3 mmol/L KFactor = 0
    • Else KFactor = 3.
  • NaFactor is assigned values by this ordered logic:
    • If Serum sodium ≥145 mmol/L NaFactor = 1
    • Else if Serum sodium ≥125 mmol/L NaFactor = 0
    • Else NaFactor = 5.
  • HCO3Factor is assigned values by this ordered logic:
    • If Serum bicarbonate ≥20 mEq/L HCO3Factor = 0
    • Else if Serum bicarbonate ≥15 mEq/L HCO3Factor = 3
    • Else HCO3Factor = 6.
  • BiliFactor is assigned values by this ordered logic:
    • If Serum bilirubin ≥6 mg/dL BiliFactor = 9
    • Else if Serum bilirubin ≥4 mg/dL BiliFactor = 4
    • Else BiliFactor = 0.
  • GCSFactor is assigned values by this ordered logic:
    • If Glasgow coma score ≥14 points GCSFactor = 0
    • Else if Glasgow coma score ≥11 points GCSFactor = 5
    • Else if Glasgow coma score ≥9 points GCSFactor = 7
    • Else if Glasgow coma score ≥6 points GCSFactor = 13
    • Else GCSFactor = 26.

 
References
  1. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993 Dec 22-29;270(24):2957-63. PubMed ID: 8254858 PubMed Logo

 
Associated Logical Observation Identifiers Names and Codes [LOINC]
 
Parameter LOINC's and Suggested Units
Age 21612-7 : yr      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years      
HR 8867-4 : beats/min      8893-0 : beats/min      8890-6 : beats/min      8889-8 : beats/min      68999-2 : beats/min      76282-3 : beats/min      69000-8 : beats/min      
SBP 8480-6 : mmHg      
Temp 8329-5 : degC      8310-5 : degC      8331-1 : degC      8332-9 : degC      8333-7 : degC      8328-7 : degC      
BUN 3094-0 : mg/dL      6299-2 : mg/dL      14937-7 : mmol/L      59570-2 : mmol/L      
WBC 6690-2 : #/microL      
K 2823-3 : mEq/L      6298-4 : mEq/L      
Na 2951-2 : mmol/L      2947-0 : mEq/L      32340-2 : mEq/L      39791-9 : mEq/L      
HCO3 2028-9 : mmol/L      1959-6 : mEq/L      1960-4 : mEq/L      14627-4 : mEq/L      1961-2 : mEq/L      22735-5 : mEq/L      1963-8 : mEq/L      
Bili 1975-2 : mg/dL      32303-0 : mmol/L      59828-4 : mg/dL      54363-7 : mcmol/L      58941-6 : mg/dL      
GCS 9269-2 : score      

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

 
Associated ICD10-CM Codes
 
   J96.90Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia
   J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
   A41.9Sepsis, unspecified organism
   I50.9Heart failure, unspecified
   I50.9Heart failure, unspecified
   N19Unspecified kidney failure

 
Associated ICD9-CM Codes
 
   584.9Acute renal failure nos
   586Renal failure nos
   428.9Heart failure nos
   038.9Septicemia nos
   518.81Acute respiratry failure

 
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