Derivation of Novel Risk Prediction Scores for Community-Acquired Sepsis and Severe Sepsis*

Abstract

Objective We sought to derive and internally validate a Sepsis Risk Score (SRS) and a Severe Sepsis Risk Score (SSRS) predicting long-term risks of future sepsis and severe sepsis events among community-dwelling adults. Design National population-based cohort. Setting United States. Subjects 30,239 community-dwelling adults ≥45 years old in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Interventions None. Measurements and Main Results Over a median of 6.6 years (IQR 5.1-8.1) of follow-up, there were 1,532 first sepsis (incidence 8.3 per 1000 person-years) and 1,151 first severe sepsis (6.2 per 1,000 person-years) events. Risk factors in the best derived SRS and SSRS included: chronic lung disease, age≥75 years, peripheral artery disease, diabetes, tobacco use, white race, stroke, atrial fibrillation, coronary artery disease, obesity, hypertension, deep vein thrombosis, male sex, high-sensitivity C-reactive protein >3.0 mg/dL, Cystatin C ≥1.11 mg/dL, estimated glomerular filtration rate <60 mL/min/1.73m2, and albumin-to-creatinine ratio >30 mcg/mg. SRS risk categories were: very low (0-3 points; 2.3 events per 1,000 person-years), low (4-6; 4.1), medium (7-9; 6.5), high (10-12; 9.7), and very high (13-38; 21.1). SSRS risk categories were: very low (0-5 points;1.5 events per 1,000 person-years), low (6-9; 3.4), medium (10-13; 6.7), high (14-17; 9.9), and very high (18-45; 22.1). The SRS and SSRS exhibited good discrimination (bootstrapped C Index 0.703 and 0.742) and calibration (p=0.65 and 0.06). Conclusions The SRS and SSRS predict 10-year sepsis and severe sepsis risk among community-dwelling adults and may aid in sepsis prevention or mitigation efforts.

Aspirin use and long-term rates of sepsis: A population-based cohort study

“…Societal rates of MI, stroke, or cardiovascular disease mortality have been mitigated by organized prevention efforts [ 39 ]. In prior studies we have identified a host of novel risk factors associated with sepsis susceptibility [ 40 ]. Additional study must identify other potential interventions to limit and reduce long-term rates of sepsis.…”

Agreement of claims-based methods for identifying sepsis with clinical criteria in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort

“…Medical conditions included atrial fibrillation, chronic kidney disease (CKD), diabetes, dyslipidemia, hypertension, lung disease, myocardial infarction (MI), obesity, and stroke [22,23]. Using baseline characteristics, we calculated a Sepsis Risk Score for each participant [24]. Year of hospitalization and age at the time of hospitalization were also determined.…”

Сепсис: Традиції Та Інновації В Термінології, Патогенезі, Діагностиці, Інтенсивній Терапії — Заради Врятування Та Збереження Життя Хворого

“…Выбор инфузи-онной среды -все, в чем можно плавать! Факторы риска в шкалах Sepsis Risk Score и Severe Sepsis Risk Score (H. Wang et al, 2016): возраст более 75 лет, белая раса, табакокурение, хроническое за-болевание легких, заболевания периферических ар-терий, диабет, инсульт, фибрилляция предсердий, ишемическая болезнь сердца (ИБС), ожирение, ги-пертензия, тромбоз глубоких вен, мужской пол, СРБ > 3 мг/дл, цистатин С  11 мг/дл, клубочковая филь-трация < 60 мл/мин/1,73 м 2 . Трактовка факторов риска в шкалах Sepsis Risk Score и Severe Sepsis Risk Score: низкий риск -0-3 пунктов, средний риск -7-9 пунктов, высокий риск -10-12 пунктов [6].…”