A simple mortality prediction model for sepsis patients in intensive care

Author:

Koozi Hazem12ORCID,Lidestam Adina1,Lengquist Maria13,Johnsson Patrik14,Frigyesi Attila13

Affiliation:

1. Department of Clinical Medicine, Anaesthesiology and Intensive Care, Lund University, Lund, Sweden

2. Kristianstad Central Hospital, Anaesthesia and Intensive Care, Kristianstad, Sweden

3. Skåne University Hospital, Intensive and Perioperative Care, Lund, Sweden

4. Skåne University Hospital, Intensive and Perioperative Care, Malmö, Sweden

Abstract

Background: Sepsis is common in the intensive care unit (ICU). Two of the ICU’s most widely used mortality prediction models are the Simplified Acute Physiology Score 3 (SAPS-3) and the Sequential Organ Failure Assessment (SOFA) score. We aimed to assess the mortality prediction performance of SAPS-3 and SOFA upon ICU admission for sepsis and find a simpler mortality prediction model for these patients to be used in clinical practice and when conducting studies. Methods: A retrospective study of adult patients fulfilling the Sepsis-3 criteria admitted to four general ICUs was performed. A simple prognostic model was created using backward stepwise multivariate logistic regression. The area under the curve (AUC) of SAPS-3, SOFA and the simple model was assessed. Results: One thousand nine hundred eighty four admissions were included. A simple six-parameter model consisting of age, immunosuppression, Glasgow Coma Scale, body temperature, C-reactive protein and bilirubin had an AUC of 0.72 (95% confidence interval (CI) 0.69–0.75) for 30-day mortality, which was non-inferior to SAPS-3 (AUC 0.75, 95% CI 0.72–0.77) ( p = 0.071). SOFA had an AUC of 0.67 (95% CI 0.64–0.70) and was inferior to SAPS-3 ( p < 0.001) and our simple model ( p = 0.0019). Conclusion: SAPS-3 has a lower prognostic value in sepsis than in the general ICU population. SOFA performs less well than SAPS-3. Our simple six-parameter model predicts mortality just as well as SAPS-3 upon ICU admission for sepsis, allowing the design of simple studies and performance monitoring.

Funder

centralsjukhuset kristianstad

Governmental grants for clinical research within the National Health Services (ALF YF)

Publisher

SAGE Publications

Subject

Critical Care and Intensive Care Medicine,Critical Care Nursing

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