Natthaka Sathaporn1, Bodin Khwannimit2. 1. Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. 2. Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. Electronic address: kbordin@medicine.psu.ac.th.
Abstract
PURPOSE: The aim of this study was to compare the performance of the New York Sepsis Severity Score (NYSSS) with the Sepsis Severity Score (SSS) and Acute Physiology and Chronic Health Evaluation and Simplified Acute Physiology Scores for predicting mortality in sepsis patients. METHOD: A retrospective analysis was conducted in the intensive care unit. The primary outcome was in-hospital mortality. RESULTS: Overall 1680 sepsis patients were enrolled. The hospital mortality rate was 44.4%. The NYSSS underestimated actual mortality with standard mortality ratio (SMR) of 1.28 (95%CI 1.19-1.38). However, the SSS slightly overestimated the actual mortality with an SMR of 0.94 (0.88-1.01). The NYSSS had moderate discrimination with an AUC of 0.772 (0.750-0.794), in contrast to the SSS which had good discrimination with an AUC of 0.889 (0.873-0.904). The AUC of the SSS was statistically higher than that of the NYSSS. The AUCs of both the NYSSS and SSS were significantly lower than other standard severity scores. The calibrations for all severity scores were poor. The SSS had better overall performance than the NYSSS (Brier score 0.149 and 0.201, respectively). CONCLUSION: The SSS had better discrimination and overall performance than the NYSSS. However, both sepsis severity scores were poorly calibrated.
PURPOSE: The aim of this study was to compare the performance of the New York Sepsis Severity Score (NYSSS) with the Sepsis Severity Score (SSS) and Acute Physiology and Chronic Health Evaluation and Simplified Acute Physiology Scores for predicting mortality in sepsispatients. METHOD: A retrospective analysis was conducted in the intensive care unit. The primary outcome was in-hospital mortality. RESULTS: Overall 1680 sepsispatients were enrolled. The hospital mortality rate was 44.4%. The NYSSS underestimated actual mortality with standard mortality ratio (SMR) of 1.28 (95%CI 1.19-1.38). However, the SSS slightly overestimated the actual mortality with an SMR of 0.94 (0.88-1.01). The NYSSS had moderate discrimination with an AUC of 0.772 (0.750-0.794), in contrast to the SSS which had good discrimination with an AUC of 0.889 (0.873-0.904). The AUC of the SSS was statistically higher than that of the NYSSS. The AUCs of both the NYSSS and SSS were significantly lower than other standard severity scores. The calibrations for all severity scores were poor. The SSS had better overall performance than the NYSSS (Brier score 0.149 and 0.201, respectively). CONCLUSION: The SSS had better discrimination and overall performance than the NYSSS. However, both sepsis severity scores were poorly calibrated.
Authors: Matthew M Churpek; Jay Dumanian; Nicole Dussault; Sivasubramanium V Bhavani; Kyle A Carey; Emily R Gilbert; Erum Arain; Chen Ye; Christopher J Winslow; Nirav S Shah; Majid Afshar; Dana P Edelson Journal: Crit Care Med Date: 2021-07-01 Impact factor: 9.296