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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

World Journal of Emergency Surgery 1/2015

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Zeitschrift:
World Journal of Emergency Surgery > Ausgabe 1/2015
Autoren:
Massimo Sartelli, Fikri M. Abu-Zidan, Fausto Catena, Ewen A. Griffiths, Salomone Di Saverio, Raul Coimbra, Carlos A. Ordoñez, Ari Leppaniemi, Gustavo P. Fraga, Federico Coccolini, Ferdinando Agresta, Asrhaf Abbas, Saleh Abdel Kader, John Agboola, Adamu Amhed, Adesina Ajibade, Seckin Akkucuk, Bandar Alharthi, Dimitrios Anyfantakis, Goran Augustin, Gianluca Baiocchi, Miklosh Bala, Oussama Baraket, Savas Bayrak, Giovanni Bellanova, Marcelo A. Beltràn, Roberto Bini, Matthew Boal, Andrey V. Borodach, Konstantinos Bouliaris, Frederic Branger, Daniele Brunelli, Marco Catani, Asri Che Jusoh, Alain Chichom-Mefire, Gianfranco Cocorullo, Elif Colak, David Costa, Silvia Costa, Yunfeng Cui, Geanina Loredana Curca, Terry Curry, Koray Das, Samir Delibegovic, Zaza Demetrashvili, Isidoro Di Carlo, Nadezda Drozdova, Tamer El Zalabany, Mushira Abdulaziz Enani, Mario Faro, Mahir Gachabayov, Teresa Giménez Maurel, Georgios Gkiokas, Carlos Augusto Gomes, Ricardo Alessandro Teixeira Gonsaga, Gianluca Guercioni, Ali Guner, Sanjay Gupta, Sandra Gutierrez, Martin Hutan, Orestis Ioannidis, Arda Isik, Yoshimitsu Izawa, Sumita A. Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Saila Kauhanen, Robin Kaushik, Jakub Kenig, Vladimir Khokha, Jae Il Kim, Victor Kong, Renol Koshy, Avidyl Krasniqi, Ashok Kshirsagar, Zygimantas Kuliesius, Konstantinos Lasithiotakis, Pedro Leão, Jae Gil Lee, Miguel Leon, Aintzane Lizarazu Pérez, Varut Lohsiriwat, Eudaldo López-Tomassetti Fernandez, Eftychios Lostoridis, Raghuveer Mn, Piotr Major, Athanasios Marinis, Daniele Marrelli, Aleix Martinez-Perez, Sanjay Marwah, Michael McFarlane, Renato Bessa Melo, Cristian Mesina, Nick Michalopoulos, Radu Moldovanu, Ouadii Mouaqit, Akutu Munyika, Ionut Negoi, Ioannis Nikolopoulos, Gabriela Elisa Nita, Iyiade Olaoye, Abdelkarim Omari, Paola Rodríguez Ossa, Zeynep Ozkan, Ramakrishnapillai Padmakumar, Francesco Pata, Gerson Alves Pereira Junior, Jorge Pereira, Tadeja Pintar, Konstantinos Pouggouras, Vinod Prabhu, Stefano Rausei, Miran Rems, Daniel Rios-Cruz, Boris Sakakushev, Maria Luisa Sánchez de Molina, Charampolos Seretis, Vishal Shelat, Romeo Lages Simões, Giovanni Sinibaldi, Matej Skrovina, Dmitry Smirnov, Charalampos Spyropoulos, Jaan Tepp, Tugan Tezcaner, Matti Tolonen, Myftar Torba, Jan Ulrych, Mustafa Yener Uzunoglu, David van Dellen, Gabrielle H. van Ramshorst, Giorgio Vasquez, Aurélien Venara, Andras Vereczkei, Nereo Vettoretto, Nutu Vlad, Sanjay Kumar Yadav, Tonguç Utku Yilmaz, Kuo-Ching Yuan, Sanoop Koshy Zachariah, Maurice Zida, Justas Zilinskas, Luca Ansaloni
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MS designed the study and wrote the manuscript. FMA-Z performed statistical analysis. All authors participated in the study. All authors read and approved the final manuscript.

Abstract

Background

To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression.

Methods

The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18–99) were enrolled in the WISS study.

Results

Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4.

Conclusions

WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.
Literatur
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