Levy et al identified risk factors for mortality in a patient with septic shock. These can help identify a patient who may require more aggressive management. The authors are from multiple hospitals in France.

Independent predictors of mortality from multivariate analysis:

(1) dopamine resistance (odds ratio 9.5)

(2) arterial lactate > 3.5 mmol/L (odds ratio 1.8)

(3) SOFA (sepsis-related organ failure assessment) score > 10 (odds ratio 1.4)



• Dopamine resistance was defined as a mean arterial pressure (MAP) < 70 mm Hg after an infusion of dopamine 20 micrograms per kilogram per minute.



• The sensitivity of dopamine resistance alone is 84% with specificity 74%.

• The sensitivity of both dopamine resistance and elevated lactate is 90% with specificity 92%.


A possible way to use this data:

(1) Assign 1 point to an odds ratio of 1.4 - 1.8.

(2) Assign 6 points to an odds ratio of 9.5.

(3) Create a risk score from 0 to 8.

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