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.
Specialty: Infectious Diseases