Performance of the “Tropical Intensive Care Score” in the intensive care units of Kinshasa

Abstract

Introduction: Several scores are used to assess prognosis in intensive care units (ICU). The Tropical Intensive Care Score (tropICS) has been proposed as an alternative in low income countries. Our objective was to assess the performance of tropICS in a few ICUs in Kinshasa. Methods: This was a multicenter cohort over the period 01/03 to 04/02/2021. The performance of "tropICS" was evaluated by analysis of the area under the ROC curve and calibration with the Lemeshow-Hosmer test. Results: A total of 249 patients with a mean age of 54 years with a sex ratio of 1.9 men to 1 woman were selected in four ICUs in Kinshasa. Medical (89%), surgical (8%) and traumatic (3%) conditions were the causes of admissions, with an average length of stay of 4 (2 to 7) days. The death rate was 38.2%. After analysis of the ROC curve, a tropICS value ≥ 3.8 predicted mortality with a sensitivity of 92.6%, a specificity of 77.9%, good discrimination with an area under the ROC curve of 0.85 (CI 0.80 - 0.90) and a poor calibration of with p < 0.05. Conclusion: tropICS is a simple and powerful tool for identifying high-risk patients and can be used in ICUs in Kinshasa.