ESM - Soares et al. Prognostic Scores in Cancer Patients 1

Validation of Four Prognostic Scores in Patients with Cancer Admitted to

Brazilian Intensive Care Units: Results from a Prospective Multicenter Study

Type of manuscript: Original research.

Electronic Supplementary Material

Corresponding author:

Márcio Soares MD PhD; Instituto Nacional de Câncer; Centro de Tratamento Intensivo

– 10o Andar; Pça. Cruz Vermelha, 23; Rio de Janeiro – RJ; Brazil; CEP: 20230-130

Phone: +55 21 2506 6120; Fax: +55 21 2294 8620

E-mail: [email protected] ESM - Soares et al. Prognostic Scores in Cancer Patients 2

Table 1– Missing Laboratory Variables (n=717)

Variables n (%) Hematocrit 2 (0.3%) Hemoglobin 7 (1.0%) Platelets count 3 (0.4%) Leukocyte count 8 (1.2%) Creatinine 4 (0.6%) Urea / Blood urea nitrogen 16 (2.3%) Sodium 4 (0.6%) Potassium 7 (1.0%) Blood gas analyses 75 (10.5%) Bilirubin 342 (47.7%) Prothrombin time 110 (15.3%) Albumin 376 (52.4%) ICU=intensive care unit; IQR=25%-75% interquartile range ESM - Soares et al. Prognostic Scores in Cancer Patients 3

Table 2. Hosmer-Lemeshow goodness-of-fit C-statistics, predicted mortality rates and standardized mortality ratios for the different customized equations of the SAPS 3 prognostic model.

Prognostic model Goodness-of-fit C-test Predicted Mortality SMR (95% CI) 2 p-value (Mean  SD) All patients admitted to ICU (n = 717; observed hospital mortality = 30.4%) General quation 15.804 0.045 23.6 ± 26.3 1.29 (1.09 – 1.53) Central and South America 12.608 0.126 29.8 ± 30.5 1.02 (0.87 – 1.19) Australasia 15.950 0.043 21.8 ± 24.8 1.40 (1.17 – 1.67) Central and Western Europe 21.079 0.007 20.8 ± 25.5 1.46 (1.22 – 1.75) Eastern Europe 18.508 0.018 25.9 ± 30.5 1.17 (0.99 – 1.38) Northern Europe 17.602 0.024 22.5 ± 26.5 1.35 (1.14 – 1.61) Southern and Mediterranean Europe 13.571 0.094 23.9 ± 25.7 1.27 (1.07 – 1.51) North America 12.858 0.117 20.8 ± 21.4 1.46 (1.22 – 1.75) AROC = area under receiver operating characteristic curve; CI = confidence interval, SD = standard deviation; SMR = standardized mortality rate, SAPS=Simplified Acute Physiology Score

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Figure Legends

Figure 1 Receiver operating characteristic curves for the different prognostic scores in medical and emergency surgical patients with cancer admitted to the intensive care units

(n=336). Figure 2a: MPM0-III (solid black line) and CMM (gray solid line). Figure 2b:

SAPS II solid black line and SAPS 3 (gray solid line). The diagonal dotted line represents reference line.

Figure 2. Calibration curves for the different prognostic scores in medical and emergency surgical patients with cancer admitted to the intensive care units (n=336).

Figure 2a: MPM0-III (dotted black line) and CMM (black solid line). Figure 2b: SAPS

II (solid black line), SAPS 3 (dotted black line) and SAPS 3 customized for Central and

South America (CSA) (solid gray lines). The diagonal dotted line represents the line of ideal prediction. Columns represent the number of patients in each stratum (10% of probability). ESM - Soares et al. Prognostic Scores in Cancer Patients 5

Figure 1 ESM - Soares et al. Prognostic Scores in Cancer Patients 6

Figure 2.