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. 2015 Dec 16:10:61.
doi: 10.1186/s13017-015-0055-0. eCollection 2015.

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Massimo Sartelli  1 , Fikri M Abu-Zidan  2 , Fausto Catena  3 , Ewen A Griffiths  4 , Salomone Di Saverio  5 , Raul Coimbra  6 , Carlos A Ordoñez  7 , Ari Leppaniemi  8 , Gustavo P Fraga  9 , Federico Coccolini  10 , Ferdinando Agresta  11 , Asrhaf Abbas  12 , Saleh Abdel Kader  13 , John Agboola  14 , Adamu Amhed  15 , Adesina Ajibade  16 , Seckin Akkucuk  17 , Bandar Alharthi  18 , Dimitrios Anyfantakis  19 , Goran Augustin  20 , Gianluca Baiocchi  21 , Miklosh Bala  22 , Oussama Baraket  23 , Savas Bayrak  24 , Giovanni Bellanova  25 , Marcelo A Beltràn  26 , Roberto Bini  27 , Matthew Boal  4 , Andrey V Borodach  28 , Konstantinos Bouliaris  29 , Frederic Branger  30 , Daniele Brunelli  31 , Marco Catani  32 , Asri Che Jusoh  33 , Alain Chichom-Mefire  34 , Gianfranco Cocorullo  35 , Elif Colak  36 , David Costa  37 , Silvia Costa  38 , Yunfeng Cui  39 , Geanina Loredana Curca  40 , Terry Curry  6 , Koray Das  41 , Samir Delibegovic  42 , Zaza Demetrashvili  43 , Isidoro Di Carlo  44 , Nadezda Drozdova  45 , Tamer El Zalabany  46 , Mushira Abdulaziz Enani  47 , Mario Faro  48 , Mahir Gachabayov  49 , Teresa Giménez Maurel  50 , Georgios Gkiokas  51 , Carlos Augusto Gomes  52 , Ricardo Alessandro Teixeira Gonsaga  53 , Gianluca Guercioni  54 , Ali Guner  55 , Sanjay Gupta  56 , Sandra Gutierrez  57 , Martin Hutan  58 , Orestis Ioannidis  59 , Arda Isik  60 , Yoshimitsu Izawa  61 , Sumita A Jain  62 , Mantas Jokubauskas  63 , Aleksandar Karamarkovic  64 , Saila Kauhanen  65 , Robin Kaushik  56 , Jakub Kenig  66 , Vladimir Khokha  67 , Jae Il Kim  68 , Victor Kong  69 , Renol Koshy  44 , Avidyl Krasniqi  70 , Ashok Kshirsagar  71 , Zygimantas Kuliesius  72 , Konstantinos Lasithiotakis  73 , Pedro Leão  74 , Jae Gil Lee  75 , Miguel Leon  76 , Aintzane Lizarazu Pérez  77 , Varut Lohsiriwat  78 , Eudaldo López-Tomassetti Fernandez  79 , Eftychios Lostoridis  80 , Raghuveer Mn  81 , Piotr Major  82 , Athanasios Marinis  83 , Daniele Marrelli  84 , Aleix Martinez-Perez  85 , Sanjay Marwah  86 , Michael McFarlane  87 , Renato Bessa Melo  88 , Cristian Mesina  89 , Nick Michalopoulos  90 , Radu Moldovanu  91 , Ouadii Mouaqit  92 , Akutu Munyika  93 , Ionut Negoi  94 , Ioannis Nikolopoulos  95 , Gabriela Elisa Nita  10 , Iyiade Olaoye  96 , Abdelkarim Omari  97 , Paola Rodríguez Ossa  7 , Zeynep Ozkan  98 , Ramakrishnapillai Padmakumar  99 , Francesco Pata  100 , Gerson Alves Pereira Junior  101 , Jorge Pereira  102 , Tadeja Pintar  103 , Konstantinos Pouggouras  80 , Vinod Prabhu  104 , Stefano Rausei  105 , Miran Rems  106 , Daniel Rios-Cruz  107 , Boris Sakakushev  108 , Maria Luisa Sánchez de Molina  109 , Charampolos Seretis  110 , Vishal Shelat  111 , Romeo Lages Simões  9 , Giovanni Sinibaldi  112 , Matej Skrovina  113 , Dmitry Smirnov  114 , Charalampos Spyropoulos  115 , Jaan Tepp  116 , Tugan Tezcaner  117 , Matti Tolonen  8 , Myftar Torba  118 , Jan Ulrych  119 , Mustafa Yener Uzunoglu  120 , David van Dellen  121 , Gabrielle H van Ramshorst  122 , Giorgio Vasquez  123 , Aurélien Venara  30 , Andras Vereczkei  124 , Nereo Vettoretto  125 , Nutu Vlad  126 , Sanjay Kumar Yadav  127 , Tonguç Utku Yilmaz  128 , Kuo-Ching Yuan  129 , Sanoop Koshy Zachariah  130 , Maurice Zida  131 , Justas Zilinskas  63 , Luca Ansaloni  10
Affiliations

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Massimo Sartelli et al. World J Emerg Surg. .

Abstract

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression.

Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study.

Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4.

Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

Keywords: Infections; Intra-abdominal; Sepsis; Septic shock.

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Figures

Fig. 1
Fig. 1
Distribution of the percentile WSES Sepsis Severity Score of complicated intra-abdominal infection patients for those who survived (solid line) (n = 4117) and those who died (interrupted line) (n = 416)
Fig. 2
Fig. 2
Receiver operating characteristic curve for the best WSES Sepsis Severity Score that predicted mortality in patients having complicated intra-abdominal infection, global study of 132 centres, (n = 4553)
See this image and copyright information in PMC

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