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Description

Wang et al reported a nomogram for predicting 1-year mortality for a patient with sepsis. This can help to identify a patient who may require more aggressive management and follow-up. The authors are from Dalian Medical University in China.


Patient selection: sepsis (from the MIMIC-III database from Beth Israel Deaconess Medical Center)

 

Parameters:

(1) gender

(2) serum albumin in g/dL

(3) ethnicity

(4) serum potassium in mmol/L

(5) serum LDH in IU/L

(6) respiratory failure

(7) hemoglobin in g/dL

(8) need for vasopressor support

(9) serum alkaline phosphatase in IU/L

(10) serum total calcium in mg/dL

(11) Elixhauser score, from -20 to 80 (apparently using the modified version of van Walraven et al)

(12) age in years from 17 to 90 years of age

 

points for serum albumin =

= 39.45 - (4.75 * (albumin))

 

points for serum potassium =

= (2.6 * (potassium)) + 18.4

 

points for serum LDH =

= (0.00456 * (LDH)) + 23.6

 

points for hemoglobin =

= 48.44 - (1.97 * (hemoglobin))

 

points for serum alkaline phosphatase =

= (0.0272 * (alkaline phosphatase)) + 22

 

points for serum calcium =

= (5.067 * (calcium)) - 15.2

 

points for Elixhauser score =

= (0.452 * (score)) + 14.94

 

points for age =

= (0.5117 * (age)) - 8.55

 

Parameter

Finding

Points

gender

female

25.5

 

male

30.8

ethnicity

Asian

25.8

 

Black

33

 

Hispanic

39.9

 

White

40.9

respiratory failure

no

25.8

 

yes

33.9

vasopressor support

no

26.3

 

yes

38.1

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 257.3

• maximum score: 585.2

• The higher the score the greater the 1-year mortality.

 

value of X =

= (0.06505 * (score)) - 21.37

 

risk of 1-year mortality =

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

 

Performance:

• The are under the ROC curve was 0.77 in the training and 0.75 in the testing cohorts.


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