Prognostic Scale for Discharge Status in Critical Patients with Sepsis

Abstract

Introduction: Sepsis is the leading cause of mortality in Intensive Care Units (ICUs), and predicting outcomes in patients with this syndrome remains a challenge for physicians. Objective: To validate a newly created scale for predicting discharge status in critical patients with sepsis. Methods: A prospective cohort study was conducted on 385 sepsis patients admitted to the Aleida Fernández Chardiet Teaching Surgical Clinical Hospital between 2018 and 2021. Results: The final logistic regression models with the best performance were biochemical variables (p<0.001) and treatment-related variables (p<0.001). For biochemical variables excluding lactate, calibration was good, but discrimination was inadequate. The Mayabeque sepsis scale score correlated with mortality risk in sepsis patients (p<0.001), with higher precision in high-risk patients for both versions. Internal validation was performed using resampling. Receiver operating characteristic curves showed an area under the curve of 0.83 for the model including lactate and 0.79 for the model excluding lactate in the validation sample. The Mayabeque sepsis scale’s discrimination for predicting discharge was comparable to Sequential Organ Failure Assessment,(0.83) and Acute Physiology and Chronic Health Evaluation II (0.83) but inferior to Simplified Acute Physiology III (0.88). Conclusions: The newly developed and validated scale accurately predicts discharge status in critical sepsis patients admitted to the Intensive Care Unit.