Prognostic Performance of World Society of Emergency Surgery Sepsis Severity Score in Bulgarian Patients With Complicated Intra-Abdominal Infections

Abstract

PURPOSE: To evaluate the ability of World Society of Emergency Surgery Sepsis Severity Score (WSES SSS) to prognosticate the fatal outcome in our local setting and compare the findings with global data. METHODS: The retrospective study involved 110 patients with complicated intra-abdominal infections (cIAIs) admitted to Department of Surgical Diseases at a University hospital. All adult patients who required emergency surgery due to cIAIs from January 2017 to July 2019 were included. We assessed the prognostic performance of WSES SSS using area under receiver operating characteristics (AUROC) curves and analyzed the coordinates of the curves. RESULTS: The observed in-hospital mortality was 22.7%. WSES SSS was significantly higher in non-survivors compared to survivors - 7(5-8) points vs. 3(0-5) points, p < 0.0001. The established AUROC value of WSES SSS for outcome prediction was 0.825 (0.749-0.902). We have identified sensitivity of 92% and specificity of 68.2% for cut-off value > 4 points. CONCLUSION: The WSES SSS was shown as a practical and reliable mortality predictor in Bulgarian patients with cIAIs.