Evaluating prognostic accuracy of lethality scores in patients with sepsis
Ziamko V.Y., Okulich V.K., Dzyadzko A.M.
Vitebsk State Medical University, Vitebsk, Belarus
Minsk Scientific and Practical Center of Surgery, Transplantation and Hematology, Minsk, Belarus
Objective: to identify patients with a high risk of death; objectively assess their state on the basis of a quantitative assessment using APACHE II, SAPS II, SOFA scales and also assess their immune system. Materials and methods. Evaluation of clinical and laboratory data of 126 patients with sepsis was carried out on the day of admission to the ICU and one day before the lethal outcome for the period from 2016 to 2019. Results. The score on the APACHE II and SOFA scales allows to identify patients with an increased risk of death even on the first day. The information content of the aforementioned assessment systems is about the same, however, the modified simplified scale SAPS II despite its convenience in practical application suggested that only 6.5% of patients were fatal. Independent predictors of death at entry are the level of urea and creatinine, the decrease in pH, and the increase in HCO3. The presence of gramnegative microflora was associated with high mortality (p = 0.04) in the group with sepsis, regardless the location of the pathogen. Given the small sample of patients who received intravenous immunoglobulin G no statistically significant results in reducing mortality in sepsis were obtained.