New York Sepsis Severity Score (NYSSS) of Phillips et al

Description

Phillips et al reported the New York Sepsis Severity Score for evaluating a patient with sepsis. This can be used to predict the risk of mortality for the patient. The authors are from the Ohio State University, Washington University, IPRO, Greater New York Hospital Association, Brown University and New York State Department of Health.

Patient selection: sepsis, any age

Outcome: mortality

Parameters:

(1) race or ethnicity

(2) payer

(3) site of infection

(4) admission source

(5) lower respiratory tract infection

(6) mechanical ventilation severity (on MV prior to sepsis protocol)

(7) combination of lower respiratory infection and mechanical ventilation

(8) septic shock diagnosis

(9) thrombocytopenia

(10) metastatic cancer

(11) lymphoma, leukemia or multiple myeloma

(12) age in years

(13) comorbidity count

(14) combination of age and comorbidity count

(15) initial serum lactate in mmol/L

(16) initial square of serum lactate

(17) combination of comorbidity count and serum lactate

Parameter	Finding	Points
race or ethnicity	white	0
	black	0.188
	hispanic	-0.073
	multiracial	0.165
	other	0.043
	unknown	0.101
payer	Medicare	0
	Medicaid	0.099
	private or HMO	0.067
	self-pay	0.646
	other	-0.023
site of infection	urinary	0
	respiratory	0.599
	gastrointestinal	0.543
	skin	0.484
	CNS	0.723
	other	0.558
	unknown	0.9
admission source	nonhealth facility	0
	clinic	-0.033
	different hospital	0.418
	skilled nursing facility	0.289
	another healthcare facility	0.278
	between unit transfer	0.459
	hospice	0.727
	other	-0.33
lower respiratory tract infection	no	0
	yes	0.281
mechanical ventilation severity	no	0
	yes	0.519
lower respiratory tract infection and MV	both yes	-0.398
	other	0
sepsis diagnosis	severe	0
	septic shock	0.770
thrombocytopenia	no	0
	yes	0.285
metastatic cancer	no	0
	yes	0.46
lymphoma, etc	no	0
	yes	0.135
age		0.06 * (age)
comorbidity count		2.41 * SQRT(count)
combination of age and comorbidity		-0.021 * age * SQRT(comorbidity)
serum lactate		0.245 * (lactate)
serum lactate squared		-0.002 *((lactate)^2)
combination comorbidity and serum lactate		-0.043 * (lactate) * SQRT(comorbidity)

total score =

= SUM(points for all 17 coefficients) - 8.548

probability of mortality =

= 1 / (1 + EXP((-1) * X))

Perforrmance:

• The area under the ROC curve in the original study is 0.77.

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New York Sepsis Severity Score (NYSSS) of Phillips et al

Description

Specialty