Sepsis Prediction Model for Determining Sepsis vs Systemic Inflammatory Response Syndrome (SIRS), qSOFA, and Sequential Organ Failure Assessment (SOFA)
Authors' conclusion
In this cohort study of hospital admissions, balanced accuracy of the SPM outperformed other models at higher threshold PSS; however, application of the SPM in a clinical setting was limited by poor timeliness as a sepsis screening tool as compared to SIRS and SOFA.
Study context
- Population
- All adults admitted to 5 acute care hospitals in a single US health system, June 5, 2019–December 31, 2020
- Participants
- 60,507 admissions
- Exposure
- Epic Sepsis Prediction Model vs SIRS, qSOFA and SOFA
- Outcome
- Sepsis event (≥4 days of antimicrobials, blood cultures within ±48 hours of initial antimicrobial, ≥1 organ dysfunction by eSOFA); validity and timeliness of each tool
Methodological details5 acute care hospitals, single US health system, Data analysis March 2021 to February 2023
- 5 acute care hospitals
- Single US health system
- Data analysis March 2021 to February 2023
Main finding
As reported in the abstract
Classification of sepsis admission and time to score positivity from time zero
| Group | Value | Balanced accuracy (predicting sepsis score (PSS) ≥8) | Sensitivity (change in SOFA ≥2) |
|---|---|---|---|
| Sepsis Prediction Model (SPM) | median 68.00 (IQR 6.75–605.75) minutes | 0.79 (95% CI, 0.78 to 0.80) | |
| SIRS | median 7.00 (IQR −105.00–08.00) minutes | ||
| qSOFA | median 74.00 (IQR −22.25–599.25) minutes | ||
| SOFA | median 28.00 (IQR −108.50–134.00) minutes | 0.97 (95% CI, 0.97 to 0.98) |
Value
Sepsis Prediction Model (SPM)median 68.00 (IQR 6.75–605.75) minutes
SIRSmedian 7.00 (IQR −105.00–08.00) minutes
qSOFAmedian 74.00 (IQR −22.25–599.25) minutes
SOFAmedian 28.00 (IQR −108.50–134.00) minutes
Balanced accuracy (predicting sepsis score (PSS) ≥8)
Sepsis Prediction Model (SPM)0.79 (95% CI, 0.78 to 0.80)
SIRS— not stated in the abstract
qSOFA— not stated in the abstract
SOFA— not stated in the abstract
Sensitivity (change in SOFA ≥2)
Sepsis Prediction Model (SPM)— not stated in the abstract
SIRS— not stated in the abstract
qSOFA— not stated in the abstract
SOFA0.97 (95% CI, 0.97 to 0.98)
- PSS ≥8 had the highest balanced accuracy within the vendor recommended PSS range of 5 to 8
- 0.79
- Change in SOFA ≥2 had the highest sensitivity
- 0.97
Observational data: associations, not effects.
Original publication
Sepsis Prediction Model for Determining Sepsis vs SIRS, qSOFA, and SOFA. JAMA Netw Open. Published 1 August 2023. doi:10.
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