Derivation of a new bioscore for predicting mortality in sepsis
Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with sepsis using a combination of biomarkers and clinical indexes. Materials and Methods:...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English English English |
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Kulliyyah of Medicine, International Islamic University Malaysia
2019
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| Online Access: | http://irep.iium.edu.my/71975/ http://irep.iium.edu.my/71975/7/71975%20Derivation%20of%20a%20new%20bioscore.pdf http://irep.iium.edu.my/71975/13/71975_Derivation%20of%20a%20new%20bioscore%20for%20predicting%20mortality%20in%20sepsis_scopus.pdf http://irep.iium.edu.my/71975/19/71975_Derivation%20of%20A%20New%20Bioscore%20for%20Predicting%20Mortality%20in%20Sepsis_wos.pdf |
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| author | Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina |
| author_facet | Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina |
| author_sort | Wan Shukeri, Wan Fadzlina |
| building | IIUM Repository |
| collection | Online Access |
| description | Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating
outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with
sepsis using a combination of biomarkers and clinical indexes. Materials and Methods: This was a secondary
analysis from a prospective study involving 159 patients with sepsis admitted to an intensive care unit (ICU).
Data for key variables considered for possible inclusion in the score were collected, which included: age,
sex, source of admission, comorbidities, microorganism, bacteraemia, site of infection, septic shock status,
baseline Simplified Acute Physiological Score II, Sequential Organ Failure Assessment (SOFA) score (total and
organ sub-scores), C-reactive protein, procalcitonin and interleukin-6 (IL-6). Approximate quintiles of each
variable were given points as per the strength of their association with 30-day mortality. Results: In
accordance with the statistical significance in the logistic regression analysis, the final score utilised
candidate variables of age, central nervous system and liver SOFA sub-scores and IL-6. The bioscore
predicted 30-day mortality with a very good performance [area under the receiver operating characteristic
curve 0.814 (95% confidence interval 0.745-0.871, p <0.0001)] in our sepsis cohort. A bioscore greater than 4
predicted 30-day mortality with 80.4% sensitivity, 69.9% specificity, 2.67 positive likelihood ratio and 0.28
negative likelihood ratio. As the score increased, so did mortality rate. Conclusion: A new bioscore
combining age, central nervous system and liver SOFA sub-scores and IL-6 measured on ICU admission
potentially improves prediction of mortality in sepsis. Further study is warranted to prospectively validate
the clinical utility of this bioscore in risk-stratifying patients with suspected sepsis. |
| first_indexed | 2025-11-14T17:26:36Z |
| format | Article |
| id | iium-71975 |
| institution | International Islamic University Malaysia |
| institution_category | Local University |
| language | English English English |
| last_indexed | 2025-11-14T17:26:36Z |
| publishDate | 2019 |
| publisher | Kulliyyah of Medicine, International Islamic University Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | iium-719752019-11-24T14:46:09Z http://irep.iium.edu.my/71975/ Derivation of a new bioscore for predicting mortality in sepsis Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina R Medicine (General) Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with sepsis using a combination of biomarkers and clinical indexes. Materials and Methods: This was a secondary analysis from a prospective study involving 159 patients with sepsis admitted to an intensive care unit (ICU). Data for key variables considered for possible inclusion in the score were collected, which included: age, sex, source of admission, comorbidities, microorganism, bacteraemia, site of infection, septic shock status, baseline Simplified Acute Physiological Score II, Sequential Organ Failure Assessment (SOFA) score (total and organ sub-scores), C-reactive protein, procalcitonin and interleukin-6 (IL-6). Approximate quintiles of each variable were given points as per the strength of their association with 30-day mortality. Results: In accordance with the statistical significance in the logistic regression analysis, the final score utilised candidate variables of age, central nervous system and liver SOFA sub-scores and IL-6. The bioscore predicted 30-day mortality with a very good performance [area under the receiver operating characteristic curve 0.814 (95% confidence interval 0.745-0.871, p <0.0001)] in our sepsis cohort. A bioscore greater than 4 predicted 30-day mortality with 80.4% sensitivity, 69.9% specificity, 2.67 positive likelihood ratio and 0.28 negative likelihood ratio. As the score increased, so did mortality rate. Conclusion: A new bioscore combining age, central nervous system and liver SOFA sub-scores and IL-6 measured on ICU admission potentially improves prediction of mortality in sepsis. Further study is warranted to prospectively validate the clinical utility of this bioscore in risk-stratifying patients with suspected sepsis. Kulliyyah of Medicine, International Islamic University Malaysia 2019-04 Article PeerReviewed application/pdf en http://irep.iium.edu.my/71975/7/71975%20Derivation%20of%20a%20new%20bioscore.pdf application/pdf en http://irep.iium.edu.my/71975/13/71975_Derivation%20of%20a%20new%20bioscore%20for%20predicting%20mortality%20in%20sepsis_scopus.pdf application/pdf en http://irep.iium.edu.my/71975/19/71975_Derivation%20of%20A%20New%20Bioscore%20for%20Predicting%20Mortality%20in%20Sepsis_wos.pdf Wan Shukeri, Wan Fadzlina and Mat Nor, Mohd Basri and Md Ralib, Azrina (2019) Derivation of a new bioscore for predicting mortality in sepsis. International Medical Journal Malaysia, 18 (1). pp. 81-88. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/volume_18_no_1/Pages-from-IMJMVol18No1-081-088.pdf |
| spellingShingle | R Medicine (General) Wan Shukeri, Wan Fadzlina Mat Nor, Mohd Basri Md Ralib, Azrina Derivation of a new bioscore for predicting mortality in sepsis |
| title | Derivation of a new bioscore for predicting mortality in sepsis |
| title_full | Derivation of a new bioscore for predicting mortality in sepsis |
| title_fullStr | Derivation of a new bioscore for predicting mortality in sepsis |
| title_full_unstemmed | Derivation of a new bioscore for predicting mortality in sepsis |
| title_short | Derivation of a new bioscore for predicting mortality in sepsis |
| title_sort | derivation of a new bioscore for predicting mortality in sepsis |
| topic | R Medicine (General) |
| url | http://irep.iium.edu.my/71975/ http://irep.iium.edu.my/71975/ http://irep.iium.edu.my/71975/7/71975%20Derivation%20of%20a%20new%20bioscore.pdf http://irep.iium.edu.my/71975/13/71975_Derivation%20of%20a%20new%20bioscore%20for%20predicting%20mortality%20in%20sepsis_scopus.pdf http://irep.iium.edu.my/71975/19/71975_Derivation%20of%20A%20New%20Bioscore%20for%20Predicting%20Mortality%20in%20Sepsis_wos.pdf |