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:...

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Main Authors:	Wan Shukeri, Wan Fadzlina, Mat Nor, Mohd Basri, Md Ralib, Azrina
Format:	Article
Language:	English English English
Published:	Kulliyyah of Medicine, International Islamic University Malaysia 2019
Subjects:	R Medicine (General)
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

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spelling	iium-719752019-11-24T14:46:09Z http://irep.iium.edu.my/71975/ Derivation of a new bioscore for predicting mortality in sepsis Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina R Medicine (General) 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. Kulliyyah of Medicine, International Islamic University Malaysia 2019-04 Article PeerReviewed application/pdf en http://irep.iium.edu.my/71975/7/71975%20Derivation%20of%20a%20new%20bioscore.pdf application/pdf en http://irep.iium.edu.my/71975/13/71975_Derivation%20of%20a%20new%20bioscore%20for%20predicting%20mortality%20in%20sepsis_scopus.pdf application/pdf en http://irep.iium.edu.my/71975/19/71975_Derivation%20of%20A%20New%20Bioscore%20for%20Predicting%20Mortality%20in%20Sepsis_wos.pdf Wan Shukeri, Wan Fadzlina and Mat Nor, Mohd Basri and Md Ralib, Azrina (2019) Derivation of a new bioscore for predicting mortality in sepsis. International Medical Journal Malaysia, 18 (1). pp. 81-88. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/volume_18_no_1/Pages-from-IMJMVol18No1-081-088.pdf
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina Derivation of a new bioscore for predicting mortality in sepsis
description	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.
format	Article
author	Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina
author_facet	Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina
author_sort	Wan Shukeri, Wan Fadzlina
title	Derivation of a new bioscore for predicting mortality in sepsis
title_short	Derivation of a new bioscore for predicting mortality in sepsis
title_full	Derivation of a new bioscore for predicting mortality in sepsis
title_fullStr	Derivation of a new bioscore for predicting mortality in sepsis
title_full_unstemmed	Derivation of a new bioscore for predicting mortality in sepsis
title_sort	derivation of a new bioscore for predicting mortality in sepsis
publisher	Kulliyyah of Medicine, International Islamic University Malaysia
publishDate	2019
url	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
first_indexed	2023-09-18T21:42:03Z
last_indexed	2023-09-18T21:42:03Z
_version_	1777413205583200256

Derivation of a new bioscore for predicting mortality in sepsis

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