Prognostic Performance of Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation III, and Simplified Acute Physiology Score II Scores in Patients with Suspected Infection According to Intensive Care Unit Type

Hwang, Sung-Yeon; Kim, In-Kyu; Jeong, Daun; Park, Jong-Eun; Lee, Gun-Tak; Yoo, Junsang; Choi, Kihwan; Shin, Tae-Gun; Kim, Kyuseok

doi:10.3390/jcm12196402

Cited by 4 publications

(1 citation statement)

References 38 publications

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“…One category of scoring systems predicts the risk of in-hospital or in-ICU mortality at the time of admission, while another assesses and characterizes the current severity of disease or the extent of organ dysfunction. Notable examples of these existing scoring systems include Acute Physiology and Chronic Health Evaluation II (APACHE II), Logistic Organ Dysfunction System (LODS), Simpli ed Acute Physiology Score II (SAPS II), and Sequential Organ Failure Assessment (SOFA) [9][10][11][12][13]. These scoring systems provide valuable information to healthcare providers for risk strati cation and treatment decision-making.…”

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confidence: 99%

The establishment and optimization of a long-term prognosis assessment model for patients in sepsis combined with heart failure: Based on the Medical Information Mart for Intensive Care IV database

Desheng,

Li,

Yanfei

2024

Preprint

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Introduction: Sepsis is a prevalent occurrence in clinical practice, with heart failure emerging as a frequent and severe sequelae of sepsis. Despite notable progress in therapeutic interventions, the protracted prognosis for individuals experiencing sepsis-associated heart failure (SHF) continues to be unfavorable. The primary aim of this study was to develop and validate a prognostic model designed to anticipate one-year mortality in patients diagnosed with SHF. Methods: The relevant data pertaining to patients diagnosed with sepsis-associated heart failure (SHF) was extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database using Structured Query Language (SQL). The patient cohort was subsequently randomized into a training set and a validation set at a 7:3 ratio. The training set was utilized for model development, while the validation set served for model validation. Independent prognostic factors for SHF patients were identified through forward stepwise logistic regression, and a nomogram was constructed to predict one-year mortality in SHF patients. Validation of the nomogram included assessments using multiple indicators, such as the area under the receiver operating characteristic curve (AUC), calibration curve, integrated discrimination improvement (IDI), net reclassification index (NRI), and decision curve analysis (DCA). Results: Our study included a total of 4,228 patients diagnosed with sepsis-associated heart failure (SHF), with 2,960 patients allocated to the training cohort and 1,268 patients to the validation cohort. Through stepwise regression analysis, we identified twelve independent prognostic factors and constructed a nomogram. The AUC values for the nomogram were 0.740 (95% CI = 0.712–0.764) in the training cohort and 0.745 (95% CI = 0.726–0.763) in the validation cohort. The high AUC, Net Reclassification Index (NRI), and Integrated Discrimination Improvement (IDI) values underscored the robust discriminative capability of the nomogram. Calibration curves and results from the Hosmer-Lemeshow test indicated excellent calibration, and Decision Curve Analysis (DCA) curves demonstrated the nomogram's significant clinical utility. Conclusion: The novel prognostic nomogram designed to predict one-year mortality in patients with sepsis-associated heart failure (SHF) demonstrates superior performance compared to other existing scoring systems. The nomogram holds potential for guiding clinical practice. Nevertheless, additional external prospective validation is deemed necessary to further confirm its reliability and generalizability.

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confidence: 99%

The establishment and optimization of a long-term prognosis assessment model for patients in sepsis combined with heart failure: Based on the Medical Information Mart for Intensive Care IV database

Desheng,

Li,

Yanfei

2024

Preprint

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Tensor Coupled Learning of Incomplete Longitudinal Features and Labels for Clinical Score Regression

Xiao,

Liu,

Feng

et al. 2025

IEEE Trans. Pattern Anal. Mach. Intell.

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External validation of a modified cardiovascular sequential organ failure assessment score in patients with suspected infection using the MIMIC-IV database

Hwang,

Kim,

et al. 2024

PLoS ONE

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We developed a modified cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score using an emergency department-based cohort data, incorporating norepinephrine equivalent dose and lactate to represent current clinical practice patterns for vasopressor utilization and the diagnostic significance of lactate, respectively. In this study, we sought to validate this modified CV-SOFA score in intensive care unit patients with suspected infection using the Marketplace for Medical Information in Intensive Care (MIMIC)-IV database. This was a retrospective study that utilized data from the MIMIC-IV database. Modified CV/total SOFA score and original CV/total SOFA score were compared for predicting in-hospital mortality. Area under the receiver operating characteristic curve (AUROC) and the calibration curve were employed to evaluate discrimination and calibration, respectively. A total of 29,618 ICU patients with suspected infections was analyzed. The in-hospital mortality rate was 12.4% (n = 3,675). Modified CV-SOFA score (AUROC 0.667; 95% confidence interval [CI] 0.657–0.677 vs. 0.663; 95% CI 0.654–0.673; p = 0.283) and modified total SOFA score (0.784 [95% CI 0.776–0.793] vs. 0.785 [95% CI 0.777–0.793], p = 0.490) did not differ significantly from the original CV-SOFA score and original total SOFA score, respectively. The calibration curve of the original CV-SOFA score was inferior to that of the modified CV-SOFA score. The modified CV- and total SOFA scores were better calibrated than the original CV- and total SOFA scores, but their discriminative performance was not significantly different. Further studies of the modified CV-SOFA score in different settings and populations are required to assess the generalizability of this score.

show abstract

Prognostic Performance of Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation III, and Simplified Acute Physiology Score II Scores in Patients with Suspected Infection According to Intensive Care Unit Type

Cited by 4 publications

References 38 publications

The establishment and optimization of a long-term prognosis assessment model for patients in sepsis combined with heart failure: Based on the Medical Information Mart for Intensive Care IV database

The establishment and optimization of a long-term prognosis assessment model for patients in sepsis combined with heart failure: Based on the Medical Information Mart for Intensive Care IV database

Tensor Coupled Learning of Incomplete Longitudinal Features and Labels for Clinical Score Regression

External validation of a modified cardiovascular sequential organ failure assessment score in patients with suspected infection using the MIMIC-IV database

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