World Society of Emergency Surgery (WSES) Sepsis Severity Score for Patients with Complicated Intra-Abdominal Infections

Description

Sartelli et al reported a sepsis severity score for patients with complicated intra-abdominal infections. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals from around the world and members of the World Society of Emergency Surgery (WSES).

Patient selection: sepsis associated with complicated intra-abdominal infection (localized or diffuse peritonitis) in adults (age > 18 years)

Parameters:

(1) clinical status on admission

(2) setting of acquisition

(3) origin of intra-abdominal infection

(4) delay in source control

(5) age in years

(6) immunosuppression (chronic corticosteroids, immunosuppressant agents, chemotherapy, etc)

Parameter	Finding	Points
clinical status on admission	severe sepsis	3
	septic shock	5
	other	0
setting of acquisition	healthcare associated	2
	other	0
origin of infection	colonic non-diverticular perforation peritonitis	2
	small bowel perforation peritonitis	3
	diverticular diffuse peritonitis	2
	post-operative diffuse peritonitis	2
	other	0
delay in source control	none	0
	delayed (preoperative duration of peritonitis > 24 hours)	3
age	<= 70 years	0
	> 70 years	2
immunosuppression	no	0
	yes	3

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 18

• The higher the score the more severe the patient's condition and the greater the risk of mortality.

Score	Mortality
0 to 3	0.6%
4 to 6	6.3%
7 to 18	42%
9 to 18	56%
11 to 18	68%
13 to 18	81%

Performance:

• A cutoff of 5.5 had a sensitivity of 89% and specificity of 84% for mortality. The positive likelihood ratio was 5.4.

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World Society of Emergency Surgery (WSES) Sepsis Severity Score for Patients with Complicated Intra-Abdominal Infections

Description

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