Sepsis Severity Score of Osborn et al

Description

Osborn et al reported the Sepsis Severity Score based on data from the Surviving Sepsis Campaign. This can be used to estimate the risk of hospital mortality. The authors are from Washington University, the Ohio State University, California Pacific Medical Center, Cooper University Hospital and Rhode Island Hospital.

Patient selection: suspected or confirmed sepsis

Outcome: hospital mortality

Parameters:

(1) location at time of sepsis onset

(2) geographic region

(3) cardiovascular organ failure

(4) blood lactate in mmol/L

(5) hypotension

(6) resuscitation fluid

(7) vasopressors

(8) pneumonia

(9) urinary tract infection

(10) abdominal infection

(11) meningitis

(12) intravascular catheter

(13) device

(14) other infection

(15) renal organ failure

(16) hepatic organ failure

(17) hematologic organ failure

(18) mechanical ventilation and pulmonary organ failure

(19) body temperature in °C

(20) chills with rigor

(21) respiratory rate in breaths per minute

(22) white blood cell count

(23) blood glucose

(24) acute change in mental status

Parameter	Finding	Point
location at time of sepsis onset	Emergency Department	0
	hospital ward	10
	ICU	11
geographic region	Europe	9
	North America	0
	South America	14
cardiovascular organ failure	no	0
	yes	8
blood lactate	<= 4 mmol/L	0
	> 4 mmol/L	18
hypotension	absent	0
	responsive hypotension	9
	unresponsive hypotension	10
resuscitation fluid	< 20 mL per kg crystalloid or equivalent	0
	>= 20 mL per kg	1
vasopressors	no	0
	yes	9
pneumonia	no	0
	yes	9
urinary tract infection	no	0
	yes	5
abdominal infection	no	0
	yes	8
meningitis	no	0
	yes	2
intravascular catheter	no	0
	yes	9
device	no	0
	yes	10
other infection	no	0
	yes	8
renal organ failure	no	0
	yes	9
hepatic organ failure	no	0
	yes	8
hematologic organ failure	no	0
	yes	10
pulmonary organ failure	none	0
	pulmonary OF without mechanical ventilation	8
	MV with plateau pressure < 30 cm H2O and no pulmonary OF	14
	MV with plateau pressure < 30 cm H2O and pulmonary OF	14
	MV with plateau pressure >= 30 cm H2O	17
temperature	hyperthermia (> 38.3°C)	2
	normothermia	0
	hypothermia (< 36°C)	9
chills with rigors	no	0
	yes	2
respiratory rate	<= 20 breaths per min	0
	> 20 breaths per min (tachypnea)	7
white blood cell count	>= 4,000 per µL	0
	< 4,000 per µL	9
blood glucose	<= 120 mg/dL	0
	> 120 mg/dL	4
acute change in mental status	no	0
	yes	8

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 205

X =

= (0.0366 * (score)) - 2.8334

probability of hospital mortality =

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

Performance:

• The area under the ROC curve is 0.74.

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Sepsis Severity Score of Osborn et al

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