The New York Sepsis Severity Score: Development of a Risk-Adjusted Severity Model for Sepsis

医学 逻辑回归 接收机工作特性 败血症 感染性休克 心理干预 急诊医学 统计 内科学 数学 精神科
作者
Gary Phillips,Tiffany M. Osborn,Kathleen M. Terry,Foster Gesten,Mitchell M. Levy,Stanley Lemeshow
出处
期刊:Critical Care Medicine [Lippincott Williams & Wilkins]
卷期号:46 (5): 674-683 被引量:22
标识
DOI:10.1097/ccm.0000000000002824
摘要

Objectives: In accordance with Rory’s Regulations, hospitals across New York State developed and implemented protocols for sepsis recognition and treatment to reduce variations in evidence informed care and preventable mortality. The New York Department of Health sought to develop a risk assessment model for accurate and standardized hospital mortality comparisons of adult septic patients across institutions using case-mix adjustment. Design: Retrospective evaluation of prospectively collected data. Patients: Data from 43,204 severe sepsis and septic shock patients from 179 hospitals across New York State were evaluated. Settings: Prospective data were submitted to a database from January 1, 2015, to December 31, 2015. Interventions: None. Measurement and Main Results: Maximum likelihood logistic regression was used to estimate model coefficients used in the New York State risk model. The mortality probability was estimated using a logistic regression model. Variables to be included in the model were determined as part of the model-building process. Interactions between variables were included if they made clinical sense and if their p values were less than 0.05. Model development used a random sample of 90% of available patients and was validated using the remaining 10%. Hosmer-Lemeshow goodness of fit p values were considerably greater than 0.05, suggesting good calibration. Areas under the receiver operator curve in the developmental and validation subsets were 0.770 (95% CI, 0.765–0.775) and 0.773 (95% CI, 0.758–0.787), respectively, indicating good discrimination. Development and validation datasets had similar distributions of estimated mortality probabilities. Mortality increased with rising age, comorbidities, and lactate. Conclusions: The New York Sepsis Severity Score accurately estimated the probability of hospital mortality in severe sepsis and septic shock patients. It performed well with respect to calibration and discrimination. This sepsis-specific model provides an accurate, comprehensive method for standardized mortality comparison of adult patients with severe sepsis and septic shock.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
棒棒糖完成签到,获得积分10
刚刚
sometimesawake完成签到,获得积分10
1秒前
大王完成签到,获得积分10
1秒前
nater2ver完成签到,获得积分10
2秒前
古古怪界丶黑大帅完成签到,获得积分10
4秒前
lawson完成签到,获得积分10
4秒前
单纯威完成签到,获得积分10
4秒前
Apr9810h完成签到 ,获得积分10
4秒前
123完成签到,获得积分10
5秒前
科研小天才完成签到,获得积分10
6秒前
12321完成签到,获得积分10
6秒前
颜凡桃完成签到,获得积分10
6秒前
changyongcheng完成签到 ,获得积分10
6秒前
油麦菜完成签到 ,获得积分10
8秒前
hyf完成签到 ,获得积分10
9秒前
bigger.b完成签到,获得积分10
9秒前
敏感的百招完成签到,获得积分10
9秒前
李怀玉完成签到,获得积分10
9秒前
喜悦的依琴完成签到,获得积分10
10秒前
10秒前
星星会开花完成签到,获得积分10
10秒前
璇璇完成签到 ,获得积分10
11秒前
jane完成签到 ,获得积分10
12秒前
13秒前
文小杰完成签到,获得积分10
14秒前
14秒前
yinxx完成签到,获得积分10
14秒前
pups发布了新的文献求助10
15秒前
General完成签到 ,获得积分10
15秒前
脱壳金蝉完成签到,获得积分10
15秒前
科研通AI2S应助英俊的丹亦采纳,获得10
16秒前
乐乐应助爱撒娇的紫菜采纳,获得10
16秒前
竞鹤完成签到,获得积分10
17秒前
DCOI发布了新的文献求助10
17秒前
Jason完成签到,获得积分10
18秒前
18秒前
aafrr完成签到 ,获得积分10
19秒前
猪皮恶人发布了新的文献求助10
19秒前
王思鲁完成签到,获得积分10
19秒前
HtObama完成签到,获得积分10
21秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968593
求助须知:如何正确求助?哪些是违规求助? 3513416
关于积分的说明 11167791
捐赠科研通 3248853
什么是DOI,文献DOI怎么找? 1794507
邀请新用户注册赠送积分活动 875170
科研通“疑难数据库(出版商)”最低求助积分说明 804671