Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
J Crit Care. 2019 Oct;53:155-161. doi: 10.1016/j.jcrc.2019.06.017. Epub 2019 Jun 19.
The aim of this study was to compare the performance of the New York Sepsis Severity Score (NYSSS) with the Sepsis Severity Score (SSS) and Acute Physiology and Chronic Health Evaluation and Simplified Acute Physiology Scores for predicting mortality in sepsis patients.
A retrospective analysis was conducted in the intensive care unit. The primary outcome was in-hospital mortality.
Overall 1680 sepsis patients were enrolled. The hospital mortality rate was 44.4%. The NYSSS underestimated actual mortality with standard mortality ratio (SMR) of 1.28 (95%CI 1.19-1.38). However, the SSS slightly overestimated the actual mortality with an SMR of 0.94 (0.88-1.01). The NYSSS had moderate discrimination with an AUC of 0.772 (0.750-0.794), in contrast to the SSS which had good discrimination with an AUC of 0.889 (0.873-0.904). The AUC of the SSS was statistically higher than that of the NYSSS. The AUCs of both the NYSSS and SSS were significantly lower than other standard severity scores. The calibrations for all severity scores were poor. The SSS had better overall performance than the NYSSS (Brier score 0.149 and 0.201, respectively).
The SSS had better discrimination and overall performance than the NYSSS. However, both sepsis severity scores were poorly calibrated.
本研究旨在比较纽约败血症严重程度评分（NYSSS）与败血症严重程度评分（SSS）和急性生理学与慢性健康评估及简化急性生理学评分对败血症患者死亡率的预测能力。
在重症监护病房进行回顾性分析。主要结局为院内死亡率。
共纳入 1680 例败血症患者。住院死亡率为 44.4%。NYSSS 的标准死亡率比（SMR）为 1.28（95%CI 1.19-1.38），低估了实际死亡率。然而，SSS 的 SMR 为 0.94（0.88-1.01），略微高估了实际死亡率。NYSSS 的区分度中等，AUC 为 0.772（0.750-0.794），而 SSS 的区分度较好，AUC 为 0.889（0.873-0.904）。SSS 的 AUC 高于 NYSSS。NYSSS 和 SSS 的 AUC 均明显低于其他标准严重程度评分。所有严重程度评分的校准均较差。SSS 的整体性能优于 NYSSS（Brier 评分分别为 0.149 和 0.201）。
SSS 比 NYSSS 具有更好的区分度和整体性能。然而，这两种败血症严重程度评分的校准都较差。
