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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)842-845
Number of pages4
JournalIndian Journal of Critical Care Medicine
Volume22
Issue number12
DOIs
Publication statusPublished - 01-12-2018

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Tertiary Healthcare
Teaching Hospitals
Sepsis
APACHE
Confidence Intervals
Organ Dysfunction Scores
Emergency Medicine
Mortality
Hospital Emergency Service
Infection
Sensitivity and Specificity
ROC Curve
Intensive Care Units
Cohort Studies
Prospective Studies
Physicians

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Badrinath, Keertana ; Shekhar, Monica ; Sreelakshmi, Moturu ; Srinivasan, Meenakshi ; Thunga, Girish ; Nair, Sreedharan ; Nileshwar, Karthik ; Balakrishnan, Athira ; Kunhikatta, Vijayanarayana. / Comparison of various severity assessment scoring systems in patients with sepsis in a tertiary care teaching hospital. In: Indian Journal of Critical Care Medicine. 2018 ; Vol. 22, No. 12. pp. 842-845.
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Comparison of various severity assessment scoring systems in patients with sepsis in a tertiary care teaching hospital. / Badrinath, Keertana; Shekhar, Monica; Sreelakshmi, Moturu; Srinivasan, Meenakshi; Thunga, Girish; Nair, Sreedharan; Nileshwar, Karthik; Balakrishnan, Athira; Kunhikatta, Vijayanarayana.

In: Indian Journal of Critical Care Medicine, Vol. 22, No. 12, 01.12.2018, p. 842-845.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of various severity assessment scoring systems in patients with sepsis in a tertiary care teaching hospital

AU - Badrinath, Keertana

AU - Shekhar, Monica

AU - Sreelakshmi, Moturu

AU - Srinivasan, Meenakshi

AU - Thunga, Girish

AU - Nair, Sreedharan

AU - Nileshwar, Karthik

AU - Balakrishnan, Athira

AU - Kunhikatta, Vijayanarayana

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N2 - 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.

AB - 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.

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