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. 2022 Oct;26(10):1099-1105.
doi: 10.5005/jp-journals-10071-24323.

Comparison of PIRO, APACHE IV, and SOFA Scores in Predicting Outcome in Patients with Sepsis Admitted to Intensive Care Unit: A Two-year Cross-sectional Study at Rural Teaching Hospital

Sameera Dronamraju  1 , Sachin Agrawal  1 , Sunil Kumar  1 , Sourya Acharya  1 , Shilpa Gaidhane  1 , Anil Wanjari  1 , Praraj Jaiswal  1 , Nipun Bawiskar  1
Affiliations

Comparison of PIRO, APACHE IV, and SOFA Scores in Predicting Outcome in Patients with Sepsis Admitted to Intensive Care Unit: A Two-year Cross-sectional Study at Rural Teaching Hospital

Sameera Dronamraju et al. Indian J Crit Care Med. 2022 Oct.

Abstract

Introduction: Though many scoring systems for prognostication of sepsis are available in the intensive care set-up, predisposition, insult, response, and organ dysfunction (PIRO) score helps to assess each patient and evaluate response to therapy. There are few studies comparing the efficacy of PIRO score with other sepsis scores. Hence, our study was planned to compare PIRO score with acute physiology and chronic health evaluation IV (APACHE IV) score and sequential (sepsis-related) organ failure assessment (SOFA) score in predicting the mortality of intensive care patients with sepsis.

Materials and methods: This prospective cross-sectional study was done in the medical intensive care unit (MICU) from August 2019 to September 2021 among patients above 18 years of age with the diagnosis of sepsis. Predisposition, insult, response, and organ dysfunction score, SOFA score, and APACHE IV score on admission and at day 3 were calculated and statistically analyzed in the terms of outcome.

Results: A total of 280 patients fulfilling the inclusion criteria were included in the study, the mean age was 59.38 ± 15.9 years. There was a significant association of PIRO score, SOFA score, and APACHE IV score on admission and at day 3 with mortality (p-value <0.05). Among all three parameters, the PIRO score on admission and at day 3 was the best predictor of mortality at cut-off points of >14 and >16 with 92.50% and 96.50% chances of correctly predicting mortality, respectively.

Conclusion: Predisposition, insult, response, and organ dysfunction score can be considered as a strong predictor of prognostication of patients with sepsis admitted to the intensive care unit (ICU) and predict mortality. It should be routinely used as it is a simple and comprehensive score.

How to cite this article: Dronamraju S, Agrawal S, Kumar S, Acharya S, Gaidhane S, Wanjari A, et al. Comparison of PIRO, APACHE IV, and SOFA Scores in Predicting Outcome in Patients with Sepsis Admitted to Intensive Care Unit: A Two-year Cross-sectional Study at Rural Teaching Hospital. Indian J Crit Care Med 2022;26(10):1099-1105.

Keywords: Acute physiology and chronic health evaluation IV; Intensive care unit; Organ failure; Outcome; Sepsis; Sequential (sepsis-related) organ failure assessment.

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Conflict of interest statement

Source of support: This study was funded by Indian Council of Medical Research. The approval for the same was obtained via an approval letter dated 02.09.2020, number 3/2/June-2020/PG-Thesis-HRD (23). Conflict of interest: None

Figures

Flowchart 1
Flowchart 1
Flowchart showing scheme of study
Fig. 1
Fig. 1
Receiver operating characteristic curve of PIRO, SOFA, and APACHE IV score on admission for predicting mortality
Fig. 2
Fig. 2
Receiver operating characteristic curve of PIRO, SOFA, and APACHE IV score on day 3 for predicting mortality
See this image and copyright information in PMC

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