Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors

Wen Li; Meiping Wang; Bo Zhu; Yibing Zhu; Xiuming Xi

doi:10.1093/burnst/tkz006

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Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors

更新时间：2022-06-09

- Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors
- Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors
- Burns & Trauma 2020年8卷第1期
- 作者机构：
  
  1. Department of Critical Care Medicine
  2. Department of Epidemiology and Health Statistics
  3. Department of Statistics
- 作者简介：
- 基金信息：
  
  This work was supported by the National Science and Technology Support Program (2012BAI11B05).
- DOI：10.1093/burnst/tkz006
  中图分类号：
- 纸质出版日期：2020，
  
  网络出版日期：2020-1-16，
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Wen Li, Meiping Wang, Bo Zhu, 等. Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors[J]. Burns & Trauma, 2020,8(1).

Wen Li, Meiping Wang, Bo Zhu, Yibing Zhu, Xiuming Xi, Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors, Burns & Trauma, Volume 8, 2020, tkz006, https://doi.org/10.1093/burnst/tkz006
Wen Li, Meiping Wang, Bo Zhu, 等. Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors[J]. Burns & Trauma, 2020,8(1). DOI： 10.1093/burnst/tkz006.

Wen Li, Meiping Wang, Bo Zhu, Yibing Zhu, Xiuming Xi, Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors, Burns & Trauma, Volume 8, 2020, tkz006, https://doi.org/10.1093/burnst/tkz006 DOI：

摘要

Abstract

BackgroundSepsis is the leading cause of intensive care unit (ICU) admission. The purpose of this study was to explore the prognostic value of the Sequential Organ Failure Assessment (SOFA) score

the Acute Physiological and Chronic Health Evaluation II (APACHE II) score

and procalcitonin (PCT)

albumin (ALB)

and lactate (LAC) levels in patients with sepsis.MethodsConsecutive adult patients with suspected or documented sepsis at ICU admission were recruited. Their basic vital signs and related auxiliary examinations to determine their PCT and ALB levels and APACHE II score were recorded at ICU admission

and their LAC levels and SOFA scores were recorded for one week after admission. The influence of these variables on hospital mortality was evaluated. Logistic regression was used to derive the Sepsis Hospital Mortality Score (SHMS)

a prediction equation describing the relationship between predictors and hospital mortality. The median survival time was calculated by the Kaplan–Meier method. In the validation group

the kappa value was calculated to evaluate the stability of the derived formula.ResultsThis study included 894 sepsis patients admitted to 18 ICUs in 16 tertiary hospitals. Patients were randomly assigned to an experimental group (626 cases) and validation group (258 cases). In addition

a nonsurvival group (248 patients) of the experimental group was established according to the outcome at the time of discharge. The hospital mortality rate in the experimental group was 39.6% (248/626). Univariate and multivariate regression analyses revealed that the APACHE II score (odds ratio [OR] = 1.178)

△SOFA (OR = 1.186)

△LAC (OR = 1.157)

and SOFA mean score (OR = 1.086) were independently associated with hospital mortality. The SHMS was calculated as logit(p) = 4.715 – (0.164 × APACHE II) – (0.171 × △SOFA) – (0.145 × △LAC) – (0.082 × SOFA mean). A receiver operating characteristic curve was constructed to further investigate the accuracy of the SHMS

with an area under the curve of 0.851 (95% confidence interval [CI] 0.821–0.882; p < 0.001) for hospital mortality. In the low-risk group and high-risk groups

the corresponding median survival times were 15 days and 11 days

respectively.ConclusionThe APACHE II score

△SOFA

△LAC and SOFA mean score were independently associated with hospital mortality in sepsis patients and accurately predicted the hospital mortality rate and median survival time. Data on the median survival time in sepsis patients could be provided to clinicians to assist in the rational use of limited medical resources by facilitating prudent resource allocation.Trial registrationChiCTR-ECH-13003934

retrospectively registered on August 03

2013.

关键词

Keywords

SepsisSOFAAPACHE IILactateMortalitySequential organ failure assessmentAcute Physiological and Chronic Health Evaluation II

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