The Inter-Rater Reliability of Simplified Acute Physiology Score 3 (SAPS3) among Intensive Care Unit Nurses / 대한구급학회지

BACKGROUND: Simplified acute physiology score 3 (SAPS3) was developed in 2005 to evaluate intensive care unit (ICU) performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. METHODS: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC) of the total scores and each subset were evaluated. RESULTS: The ICC (95% confidence interval) of SAPS3 score was 0.89 (0.82-0.95), that of subset I was 0.90 (0.82-0.95), subset II was 0.54 (0.35-0.73), and subset III was 0.95 (0.91-0.97). The ICC of predicted mortality was 0.91 (0.85-0.96). CONCLUSIONS: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component.

The Inter-Rater Reliability of Simplified Acute Physiology Score 3 (SAPS3) among Intensive Care Unit Nurses / 대한중환자의학회지

BACKGROUND: Simplified acute physiology score 3 (SAPS3) was developed in 2005 to evaluate intensive care unit (ICU) performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. METHODS: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC) of the total scores and each subset were evaluated. RESULTS: The ICC (95% confidence interval) of SAPS3 score was 0.89 (0.82-0.95), that of subset I was 0.90 (0.82-0.95), subset II was 0.54 (0.35-0.73), and subset III was 0.95 (0.91-0.97). The ICC of predicted mortality was 0.91 (0.85-0.96). CONCLUSIONS: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component.

Correlation between Peripheral Blood Indices and Bone Marrow Dysplasia in Myelodysplastic Syndromes / 대한임상병리학회지

BACKGROUND: Several studies about myelodysplastic syndromes (MDS) have demonstrated that patients with high score of erythrocytic and total dysplasia showed a significantly lower degree of acute myeloid leukemia (AML) development. We analyzed correlation between bone marrow dysplasia and peripheral blood indices, and estimated the value of peripheral blood indices substituted for bone marrow examination to predict the progress of MDS to AML. METHODS: RBC count, MCV, RDW, WBC count, platelet count, MPV, and PDW were measured by Coulter Counter STKS (USA). We calculated the granulation score (G-score), percentage of peudo-pelger polymorphs (PPP) in the peripheral blood film, and examined the dysplasia in bone marrow aspirates. The reticulocyte survival study was performed with the venous blood collected in CPDA-1 under sterile conditions which was incubated immediately after collection at 37degrees C. RESULTS: G-score was inversly correlated with granulocytic and total dysplasia, but highly scored PPP showed a significantly lower degree granulocytic and total dysplasia. Reticulocyte survival curves showed variable pattern according to degree of erythrocytic and total dysplasia. Patients with a high degree of erythrocytic and total dysplasia showed significant difference compared with normal control group. MPV was increased in accordance with increase in megakaryocytic and total dysplasia. A lower score for erythrocytic and total dysplasia was observed in RAEB-t than in RA and RAEB. CONCLUSIONS: It is suggested that G-score, PPP, and MPV in peripheral blood as well as reticulocyte survival curve may be good markers for bone marrow dysplasia, and erythrocytic and total dysplasia in RAEB-t is lower than in RA and RAEB. Therefore, peripheral blood indices can be used to predict the progress of MDS to AML

Distribution of HLA class I alleles and haplotypes in Korean

The antigen (phenotype), gene (allele) and haplotype frequencies of HLA class I were analysed in 4,622 Koreans. With allele frequencies of over 0.05, the most frequent HLA-A,-B and -C antigens were A2, A24, A33, A11, A26, A31; B62, B51, B44, B54, B61, B35, B58, B60; Cw3, Cw1, Cw4, Cw7. Of these A2, A24, Cw1 and Cw3 were present in very high frequencies, respectively (0.3211, 0.2200, 0.2204, and 0.3737). The most common haplotypes with frequencies larger than 0.02 were A2-Blank, A33-B44, A33-B58, A11-B62, A24-B51, A24-B54, A2-B27, B54-Cw1, B58-Cw3, B51-Blank, B61-Cw3, B62-Cw4, B35-Cw3, B44-Blank, B60-Cw3, B27-Cw1, A2-Cw3, A2-Cw1, A24-Cw1, A33-Cw3, A26-Cw3, and A11-Cw4. A significant negative linkage disequilibrium was found for the haplotypes of A2-B7, A2-B44, A2-B58, A24-B13, A24-B27, A33-B54 and A33-B62, of which frequencies were larger than 0.003. The B-C and A-C haplotypes which showed the significant negative linkage disequilibrium were B44-Cw1, B51-Cw1, B44-Cw3,B62-Blank, A2-Cw4, A2-Blank, A11-Cw3, A11-Blank and A33-Cw1 and had frequencies higher than 0.01. The findings presented here could be used per se to estimate the populational relationships or as the control data for HLA-disease investigation. Furthermore they could provide the scope for the definition of new antigens.