Wang et al developed a series of scores for predicting the risk of sepsis in community-dwelling adults. One group is used to predict sepsis and a second group severe sepsis. The authors are from the University of Alabama at Birmingham and Beth Deaconess Medical Center in Boston.
Patient: adult >= 45 years of age
Outcome: 10-year risk of severe sepsis
Parameter:
(1) age in years
(2) chronic lung disease
(3) peripheral artery disease
(4) diabetes
(5) current tobacco use
(6) race
(7) stroke
(8) atrial fibrillation
(9) coronary artery disease
(10) obesity
(11) hypertension
(12) deep vein thrombosis (DVT)
(13) gender
(14) serum high-sensitivity CRP in mg/dL
(15) serum cystatin C in mg/dL
(16) estimated glomerular filtration rate in mL per min per 1.73 square meter
(17) urine albumin-to-creatinine ratio in µg/mg
|
Parameter |
Finding |
without Biomarkers |
with Biomarkers |
|
age in years |
< 75 years |
0 |
0 |
|
|
>= 75 years |
3 |
4 |
|
chronic lung disease |
no |
0 |
0 |
|
|
yes |
2 |
5 |
|
peripheral artery disease |
no |
0 |
0 |
|
|
yes |
2 |
3 |
|
diabetes |
no |
0 |
0 |
|
|
yes |
2 |
3 |
|
current tobacco use |
no |
0 |
0 |
|
|
yes |
1 |
2 |
|
race |
white |
1 |
2 |
|
|
other |
0 |
0 |
|
stroke |
no |
0 |
0 |
|
|
yes |
2 |
2 |
|
atrial fibrillation |
no |
0 |
0 |
|
|
yes |
1 |
2 |
|
coronary artery disease |
no |
0 |
0 |
|
|
yes |
2 |
2 |
|
obesity |
no |
0 |
0 |
|
|
yes |
1 |
1 |
|
hypertension |
no |
0 |
0 |
|
|
yes |
1 |
1 |
|
deep vein thrombosis |
no |
0 |
0 |
|
|
yes |
1 |
2 |
|
gender |
male |
1 |
3 |
|
|
female |
0 |
0 |
|
CRP |
<= 3.0 mg/dL |
0 |
0 |
|
|
> 3.0 mg/dL |
0 |
3 |
|
cystatin C |
< 1.11 mg/dL |
0 |
0 |
|
|
>= 1.11 mg/dL |
0 |
5 |
|
eGFR |
>= 60 |
0 |
0 |
|
|
< 60 |
0 |
2 |
|
urine albumin-to-creatinine ratio |
< 30 µg/mg |
0 |
0 |
|
|
>= 30 µg/mL |
0 |
3 |
score for sepsis without biomarkers =
= SUM(points for all 13 parameters excluding biomarkers)
score for sepsis with biomarkers =
= SUM(points for all 17 parameters)
Interpretation:
• minimum scores: 0
• maximum score without biomarkers: 20
• maximum score with biomarkers: 45
• The higher the score the greater the severity.
|
Risk Category |
Risk Group |
Score without Biomarkers |
Severe Sepsis |
|
I |
very low |
0 to 2 |
2% |
|
II |
low |
3 or 4 |
5% |
|
III |
medium |
5 or 6 |
7% |
|
IV |
high |
7 or 8 |
12% |
|
V |
very high |
9 to 20 |
23% |
|
Risk Category |
Risk Group |
Score with Biomarkers |
Severe Sepsis |
|
I |
very low |
0 to 5 |
1.5% |
|
II |
low |
6 to 9 |
3% |
|
III |
medium |
10 to 13 |
7% |
|
IV |
high |
14 to 17 |
10% |
|
V |
very high |
18 to 45 |
22% |
Performance:
• The area under the ROC curve was 0.74.
Specialty: Infectious Diseases
