Of the 14 745 patients enrolled, 1593 were excluded (burns, coronary, and cardiac surgery patients), leaving 13 152 for model development and validation.

Mortalities varied from 13.8 per cent in Switzerland to 32.4 per cent in the United Kingdom, but it is important to note that these are crude values. The ICUs were not randomly selected and should not be assumed to be representative of all ICUs in any given country. There were more male than female patients in all countries.

Of the 37 variables collected to develop SAPS II, only 17 were included in the final score. Patients with missing information on type of admission (scheduled surgical, unscheduled surgical, medical) could not be included in the final analysis, since they could not be correctly categorized for the assignment of points. Similarly, patients with missing ventilation data for whom the PaO^FO ratio could not be calculated were excluded. These exclusions removed 155 cases from the database, so that the final SAPS II was developed and validated on 12 997 patients, of whom 8369 were in the developmental sample and 4628 in the validation sample. Variables were excluded because they were unrelated to hospital mortality in the bivariate analyses or because they were not necessary once other variables were included in the multivariate model.

Figure 1 shows the variables, ranges, and points that make up the SAPS II system. The SAPS II score is made up of 17 variables: 12 physiological variables, age, type of admission (scheduled surgical, unscheduled surgical, medical), and three variables related to underlying disease (AIDS, metastatic cancer, and hematological malignancy). Table.! gives the definitions of the variables constituting the SAPS II system.

Fig. 1 SAPS II score sheet: BP, blood pressure; VENT, ventilated; CPAP, continuous positive airways pressure; WBC, white blood cells; GCS, Glasgow Coma Scale; Met. can., metastatic cancer; Hem. mal., hematological malignancy.

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