Gabriel et al reported a model for predicting the risk of mortality for a patient with postoperative sepsis. The authors are from the University of California at San Diego.
Patient selection: postoperative sepsis
Parameters:
(1) preoperative sepsis status
(2) age in years
(3) severe COPD
(4) preoperative steroid use
(5) ASA status
(6) postoperative myocardial infarction
(7) postoperative stroke
(8) postoperative acute renal failure
(9) source of infection
(10) postoperative transfusion
|
Parameter |
Finding |
Points |
|
preoperative sepsis status |
SIRS |
1 |
|
|
sepsis |
1 |
|
|
septic shock |
2 |
|
|
none of these |
0 |
|
age in years |
< 65 years |
0 |
|
|
>= 65 years |
3 |
|
severe COPD |
no |
0 |
|
|
yes |
1 |
|
preop steroid use |
no |
0 |
|
|
yes |
1 |
|
ASA status |
1 or 2 |
0 |
|
|
3 |
2 |
|
|
4 |
5 |
|
|
5 |
10 |
|
postop myocardial infarction |
no |
0 |
|
|
yes |
2 |
|
postop stroke |
no |
0 |
|
|
yes |
2 |
|
postop acute renal failure |
no |
0 |
|
|
yes |
2 |
|
source of the infection |
deep infection |
1 |
|
|
pneumonia |
2 |
|
|
other |
2 |
|
|
none |
0 |
|
postop transfusion |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 30
• The higher the score the greater the risk of mortality.
|
Score |
Mortality Rate |
|
0 to 4 |
2% |
|
5 to 10 |
12% |
|
11 to 14 |
35% |
|
15 to 19 |
56% |
|
>= 20 |
66% |
Performance:
• The area under the ROC curve is 0.82.
Specialty: Infectious Diseases
