Comparative study of SOFA, WSESSSS, and CPIRO scoring systems as mortality predictors in a patient with complicated intra-abdominal infection

Abstract

Background: A widespread intra-abdominal organ infection or complicated intra-abdominal infection (cIAI) causes localized peritonitis, intra-abdominal abscess, and diffuse peritonitis. Patients suffer from morbidity and mortality as a result of this condition. Sepsis indicators such as SOFA, WSESSSS, and CPIRO scores were predictors of mortality in cIAI patients. We aimed to examine the performance of WSESSSS, CPIRO, and SOFA scoring systems to predict mortality in patients with cIAI. Methods: A retrospective cohort, analytic observational study was conducted to assess differences in SOFA, WSESSSS, and CPIRO scoring systems' sensitivity, specificity, and accuracy as predictors of death during treatment in cIAI patients in Dr. Soetomo General Hospital, Surabaya. Results: A total of 265 patients were evaluated. The optimal cutoff for SOFA was score 5 with sensitivity, specificity, PPV, NPV, and accuracy of 77.2%, 87.9%, 77.2%, 87.9%, and 84.2%, respectively. The optimal cutoff for WSESSSS was score 8 with sensitivity, specificity, PPV, NPV, and accuracy of 83.7%, 82.7%, 72.0%, 90.5%, and 83.0%, respectively.  The optimal cutoff for CPIRO was 4 with sensitivity, specificity, PPV, NPV, and accuracy values of 62.0%, 90.2%, 77.0%, 81.7%, and 80.4%, respectively. Patients with high scores had a higher percentage of being hospitalized longer and cost higher than patients with a low score. Conclusion: The SOFA, WSESSSS, and CPIRO scoring systems had comparable performance in predicting mortality in patients with cIAI. Considering the performance of WSESSSS, the use of WSESSSS alone may be sufficient enough to predict the outcome of patients with cIAI in Indonesia.