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Risk assessment in sepsis: a new prognostication rule by APACHE II score and serum soluble urokinase plasminogen activator receptor
Critical Care, 08/09/2012
Clinical Article
Giamarellos–Bourboulis EJ et al. – A novel prediction rule with four levels of risk in sepsis based on APACHE II score and serum suPAR (soluble urokinase plasminogen activator receptor) is proposed. Prognostication by this rule is confirmed by an independent cohort.
Methods- A prospective study cohort enrolled 1914 patients with sepsis including 62.2% with sepsis and 37.8% with severe sepsis/septic shock.
- Serum suPAR was measured in samples drawn after diagnosis by an enzyme–immunoabsorbent assay; in 367 patients sequential measurements were performed.
- After ROC analysis and multivariate logistic regression analysis a prediction rule for risk was developed.
- The rule was validated in a double–blind fashion by an independent confirmation cohort of 196 sepsis patients, predominantly severe sepsis/septic shock patients, from Sweden.
- APACHE II <17 and suPAR <12ng/ml with mortality 5.5%;
- APACHE II <17 and suPAR [greater than or equal to] 12ng/ml with mortality 17.4%;
- APACHE II [greater than or equal to] 17 and suPAR <12ng/ml with mortality 37.4%;
- APACHE II [greater than or equal to] 17 and suPAR [greater than or equal to] 12ng/ml with mortality 51.7%.
