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Establishment of a prognostic model for patients with sepsis based on SOFA: a retrospective cohort study

Authors
  • Liu, Hui1
  • Zhang, Luming1, 2
  • Xu, Fengshuo2, 3
  • Li, Shaojin4
  • Wang, Zichen5
  • Han, Didi2, 3
  • Zhang, Feng1
  • Lyu, Jun2
  • Yin, Haiyan1
  • 1 Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
  • 2 Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
  • 3 School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi Province, China
  • 4 Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
  • 5 Department of Public Health, University of California, Irvine, CA, USA
Type
Published Article
Journal
The Journal of International Medical Research
Publisher
SAGE Publications
Publication Date
Sep 29, 2021
Volume
49
Issue
9
Identifiers
DOI: 10.1177/03000605211044892
PMID: 34586931
PMCID: PMC8485318
Source
PubMed Central
Keywords
Disciplines
  • Retrospective Clinical Research Report
License
Unknown

Abstract

Objective To construct a nomogram based on the Sequential Organ Failure Assessment (SOFA) that is more accurate in predicting 30-, 60-, and 90-day mortality risk in patients with sepsis. Methods Data from patients with sepsis were retrospectively collected from the Medical Information Mart for Intensive Care (MIMIC) database. Included patients were randomly divided into training and validation cohorts. Variables were selected using a backward stepwise selection method with Cox regression, then used to construct a prognostic nomogram. The nomogram was compared with the SOFA model using the concordance index (C-index), area under the time-dependent receiver operating characteristics curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration plotting, and decision-curve analysis (DCA). Results A total of 5240 patients were included in the study. Patient’s age, SOFA score, metastatic cancer, SpO2, lactate, body temperature, albumin, and red blood cell distribution width were included in the nomogram. The C-index, AUC, NRI, IDI, and DCA of the nomogram showed that it performs better than the SOFA alone. Conclusion A nomogram was established that performed better than the SOFA in predicting 30-, 60-, and 90-day mortality risk in patients with sepsis.

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