Derivation of a new bioscore for predicting mortality in sepsis
Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with sepsis using a combination of biomarkers and clinical indexes. Materials and Methods:...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English English English |
| Published: |
Kulliyyah of Medicine, International Islamic University Malaysia
2019
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| Online Access: | http://irep.iium.edu.my/71975/ http://irep.iium.edu.my/71975/ http://irep.iium.edu.my/71975/7/71975%20Derivation%20of%20a%20new%20bioscore.pdf http://irep.iium.edu.my/71975/13/71975_Derivation%20of%20a%20new%20bioscore%20for%20predicting%20mortality%20in%20sepsis_scopus.pdf http://irep.iium.edu.my/71975/19/71975_Derivation%20of%20A%20New%20Bioscore%20for%20Predicting%20Mortality%20in%20Sepsis_wos.pdf |
| Summary: | Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating
outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with
sepsis using a combination of biomarkers and clinical indexes. Materials and Methods: This was a secondary
analysis from a prospective study involving 159 patients with sepsis admitted to an intensive care unit (ICU).
Data for key variables considered for possible inclusion in the score were collected, which included: age,
sex, source of admission, comorbidities, microorganism, bacteraemia, site of infection, septic shock status,
baseline Simplified Acute Physiological Score II, Sequential Organ Failure Assessment (SOFA) score (total and
organ sub-scores), C-reactive protein, procalcitonin and interleukin-6 (IL-6). Approximate quintiles of each
variable were given points as per the strength of their association with 30-day mortality. Results: In
accordance with the statistical significance in the logistic regression analysis, the final score utilised
candidate variables of age, central nervous system and liver SOFA sub-scores and IL-6. The bioscore
predicted 30-day mortality with a very good performance [area under the receiver operating characteristic
curve 0.814 (95% confidence interval 0.745-0.871, p <0.0001)] in our sepsis cohort. A bioscore greater than 4
predicted 30-day mortality with 80.4% sensitivity, 69.9% specificity, 2.67 positive likelihood ratio and 0.28
negative likelihood ratio. As the score increased, so did mortality rate. Conclusion: A new bioscore
combining age, central nervous system and liver SOFA sub-scores and IL-6 measured on ICU admission
potentially improves prediction of mortality in sepsis. Further study is warranted to prospectively validate
the clinical utility of this bioscore in risk-stratifying patients with suspected sepsis. |
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