Shankar-Hari et al reported a prognostic score for an adult who has had a septic episode. This can predict the risk of 1-year unplanned readmission or death. The authors are from Guys and St Thomas' Hospital, King's College London and Sunnybrook Health Sciences Centre (Toronto).
Patient selection: hospitalized adult sepsis survivor
Parameters:
(1) prior hospitalizations
(2) age in years
(3) IMD2015 measure of deprivation (quintiles)
(4) preadmission dependence
(5) comorbidities
(6) type of admission
(7) hemoglobin at admission in g/dL
(8) site of infection
|
Parameter |
Finding |
Points |
|
prior hospitalizations |
0 |
0 |
|
|
1 |
1 |
|
|
2 |
2 |
|
|
>= 3 |
4 |
|
age |
< 30 years |
0 |
|
|
30 to 39 |
0 |
|
|
40 to 49 |
1 |
|
|
50 to 59 |
1 |
|
|
60 to 69 |
2 |
|
|
70 to 79 |
2 |
|
|
>= 80 years |
3 |
|
IMD2015 |
least deprived |
0 |
|
|
2nd quntile |
0 |
|
|
3rd quintile |
0 |
|
|
4th quintile |
0 |
|
|
most deprived |
1 |
|
preadmission dependence |
none (independent) |
0 |
|
|
partial |
2 |
|
|
complete |
5 |
|
comorbidities |
0 |
0 |
|
|
1 |
2 |
|
|
2 |
3 |
|
|
3 |
4 |
|
|
>= 4 |
5 |
|
admission |
elective surgical |
0 |
|
|
emergency surgical |
1 |
|
|
medical |
2 |
|
blood hemoglobin |
> 11 g/dL |
0 |
|
|
9.1 to 11 |
0 |
|
|
7.1 to 9 |
1 |
|
|
<= 7 |
2 |
|
site of infection |
neurologic |
0 |
|
|
respiratory |
1 |
|
|
cardiovascular |
2 |
|
|
gastrointestinal |
1 |
|
|
genitourinary |
1 |
|
|
musculoskeletal |
0 |
|
|
dermatologic |
0 |
|
|
unknown |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk of unplanned readmission or death.
|
Score Strata |
30-Day Risk |
1-Year Risk |
|
0 to 4 |
12% |
30% |
|
5 or 6 |
14% |
41% |
|
7 to 10 |
19% |
55% |
|
>= 11 |
27% |
Performance:
• The area under the ROC curve is 0.68.
