Comparison of various severity assessment scoring systems in patients with sepsis in a tertiary care teaching hospital

Badrinath, Keertana and Shekhar, Monica and Sreelakshmi, Moturu and Srinivasan, Meenakshi and Thunga, Girish and Nair, Sreedharan and Rao, Karthik N and Balakrishnan, Athira and Kunhikatta, Vijayanarayana (2018) Comparison of various severity assessment scoring systems in patients with sepsis in a tertiary care teaching hospital. Indian Journal of Critical Care Medicine, 22 (12). pp. 842-845. ISSN 0972-5229

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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.

Item Type: Article
Uncontrolled Keywords: Acute Physiology and Chronic Health Evaluation II; Mortality in Emergency Department Sepsis; Predisposition; Infection; Response; and Organ Dysfunction; Sepsis; Sequential Organ Failure Assessment.
Subjects: Medicine > KMC Manipal > Medicine
Pharmacy > MCOPS Manipal > Pharmacy Practice
Depositing User: KMC Library
Date Deposited: 03 Jan 2019 06:13
Last Modified: 03 Jan 2019 06:13
URI: http://eprints.manipal.edu/id/eprint/152627

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