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. 2018 Dec;22(12):842-845.
doi: 10.4103/ijccm.IJCCM_322_18.

Comparison of Various Severity Assessment Scoring Systems in Patients with Sepsis in a Tertiary Care Teaching Hospital

Keertana Badrinath  1 , Monica Shekhar  1 , Moturu Sreelakshmi  1 , Meenakshi Srinivasan  1 , Girish Thunga  1 , Sreedharan Nair  1 , Karthik Rao Nileshwar  2 , Athira Balakrishnan  1 , Vijayanarayana Kunhikatta  1
Affiliations

Comparison of Various Severity Assessment Scoring Systems in Patients with Sepsis in a Tertiary Care Teaching Hospital

Keertana Badrinath et al. Indian J Crit Care Med. 2018 Dec.

Abstract

Background: Sepsis is a complex condition defined by the systemic response to infection. Severity assessment scoring systems are used to aid the physician in deciding whether aggressive treatment is needed or not. In this study, various severity assessment scoring systems, namely Acute Physiology and Chronic Health Evaluation II (APACHE II), Rapid Emergency Medicine Score (REMS), Sequential Organ Failure Assessment (SOFA), Multiple Organ Dysfunction Score (MODS), Predisposition, Infection, Response, and Organ Dysfunction (PIRO), and Mortality in Emergency Department Sepsis (MEDS), were compared to assess their sensitivity and specificity.

Materials and methods: A prospective cohort study was conducted over 6 months. The study was conducted in the intensive care unit (ICU) of a tertiary care teaching hospital. All patients above 18 years of age with confirmed sepsis diagnosis and a well-defined outcome were included in the study.

Results: A total of 193 patients were included in the study. The mean age was 57.2 ± 15.3 (mean ± standard deviation) years. Majority of the patients were male, 125 (64.76%). Overall mortality was 108 (55.9%). The calculated area under the receiver operating characteristic curve was 0.86 (95% confidence interval [CI]: 0.80-0.90) for APACHE II, 0.81 (95% CI: 0.75-0.87) for REMS, 0.80 (95% CI: 0.74-0.86) for SOFA, 0.74 (95% CI: 0.67-0.80) for MODS, 0.78 (95% CI: 0.71-0.84) for PIRO, and 0.77 (95% CI: 0.71-0.83) for MEDS. Sensitivity and specificity for APACHE II were 81.5 and 75.3, respectively.

Conclusions: In our study, APACHE II score was found to be the most sensitive and specific in predicting the severity of sepsis compared to other scores.

Keywords: Acute Physiology and Chronic Health Evaluation II; Infection; Mortality in Emergency Department Sepsis; Predisposition; Response; Sepsis; Sequential Organ Failure Assessment; and Organ Dysfunction.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of ROC curves. ROC: Receiver operating characteristic; APACHE II: Acute Physiology and Chronic Health Evaluation II; REMS: Rapid Emergency Medicine Score; SOFA: Sequential Organ Failure Assessment; MODS: Multiple Organ Dysfunction Score; PIRO: Predisposition, Infection, Response, and Organ Dysfunction; MEDS: Mortality in Emergency Department Sepsis
See this image and copyright information in PMC

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