The Septic Severity Score was developed by Stevens at the University of Utah in 1983. It is intended to gauge the severity of the multi-organ involvement in a patient with the sepsis syndrome.
Organ systems evaluated:
(6) gastrointestinal tract
Point scoring: Abnormal findings assigned a score from 1 to 5 according to the severity of the dysfunction.
breathing room air
oxygen by mask
intubated. no PEEP
PEEP > 10% with PaO2 > 50 mm Hg
maximal PEEP, with PaO2 <= 50 mm Hg
serum creatinine < 1.5 mg/dL
serum creatinine 1.5 - 2.5 mg/dL
serum creatinine 2.6 - 3.5 mg/dL
serum creatinine > 3.6 mg/dl with good urine output (> 50 mL per hour)
serum creatinine > 3.6 mg/dL with urine volume 20-50 mL per hour
serum creatinine > 3.6 mg/dL with urine volume < 20 mL per hour
no ecchymoses and normal coagulation tests
ecchymoses and normal coagulation tests
PT 12-14 seconds or PTT 45-65 seconds
platelet count 20,000 - 100,000 per µL, PT > 14 seconds, PTT > 50 seconds
platelet count < 20,000 per µL with PT > 14 seconds and PTT > 50 seconds
evidence of DIC, bleeding
livedo, moderate hypertension
vasopressors required at moderate doses
vasopressors required at large doses
profound hypotension despite maximal vasopressor doses
normal liver function tests
LDH and SGOT increased, bilirubin normal
bilirubin 1.5 - 2.5 mg/dL
bilirubin 2.6 - 4.0 mg/dL
bilirubin 4.1 - 8.0 mg/dL
precoma with bilirubin > 8.0 mg/dL
bleeding due to erosive gastritis
mesenteric venous thrombosis
after Table page 1191
• In Table page 1191, the specifications for the coagulation ratings are a bit vague for ratings 2 and 3 (should these be OR or AND). Also the variability between laboratories for normal ranges of PT and aPTT may not be easily accounted for with the absolute values given for PT and PTT.
• In Table page 1191, the bilirubin for liver rating 3 has an upper limit of 4; for liver rating 4 the lower limit is 4.9.
septic severity score =
= ((points for organ with highest score) ^ 2) + ((points for organ with second highest score) ^ 2) + ((points for organ with third highest score) ^ 2)
estimated length of stay in survivors in days =
= (0.61 * (septic severity score)) + 12
• minimum score: 0
• maximum score: 75
• The higher the septic severity score, the more severe the sepsis.
• The mean SSS for nonsurvivors was 49, while the mean SSS for survivors was 29. While survivors showed scores from 0 to 60, nonsurvivors had scores > 30.
• Improvement in the score usually correlates with clinical improvement of the patient.
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Purpose: To use the Septic Severity Score to gauge the severity of sepsis in surgical intenstive care patients.
Specialty: Critical Care, Emergency Medicine, Infectious Diseases
Objective: criteria for diagnosis, severity, prognosis, stage, failure handling and therapy escalation, disease progression
ICD-10: A40, A41, R57.2, R65.1,