Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Sartelli, Massimo and Abu-Zidan, Fikri M. and Catena, Fausto and Griffiths, Ewen A. and Di Saverio, Salomone and Coimbra, Raul and Ordoñez, Carlos A. and Leppaniemi, Ari and Fraga, Gustavo P. and Coccolini, Federico and Agresta, Ferdinando and Abbas, Asrhaf and Abdel Kader, Saleh and Agboola, John and Amhed, Adamu and Ajibade, Adesina and Akkucuk, Seckin and Alharthi, Bandar and Anyfantakis, Dimitrios and Augustin, Goran and Baiocchi, Gianluca and Bala, Miklosh and Baraket, Oussama and Bayrak, Savas and Bellanova, Giovanni and Beltràn, Marcelo A. and Bini, Roberto and Boal, Matthew and Borodach, Andrey V. and Bouliaris, Konstantinos and Branger, Frederic and Brunelli, Daniele and Catani, Marco and Che Jusoh, Asri and Chichom-Mefire, Alain and Cocorullo, Gianfranco and Colak, Elif and Costa, David and Costa, Silvia and Cui, Yunfeng and Curca, Geanina Loredana and Curry, Terry and Das, Koray and Delibegovic, Samir and Demetrashvili, Zaza and Di Carlo, Isidoro and Drozdova, Nadezda and El Zalabany, Tamer and Enani, Mushira Abdulaziz and Faro, Mario and Gachabayov, Mahir and Giménez Maurel, Teresa and Gkiokas, Georgios and Gomes, Carlos Augusto and Gonsaga, Ricardo Alessandro Teixeira and Guercioni, Gianluca and Guner, Ali and Gupta, Sanjay and Gutierrez, Sandra and Hutan, Martin and Ioannidis, Orestis and Isik, Arda and Izawa, Yoshimitsu and Jain, Sumita A. and Jokubauskas, Mantas and Karamarkovic, Aleksandar and Kauhanen, Saila and Kaushik, Robin and Kenig, Jakub and Khokha, Vladimir and Kim, Jae Il and Kong, Victor and Koshy, Renol and Krasniqi, Avidyl and Kshirsagar, Ashok and Kuliesius, Zygimantas and Lasithiotakis, Konstantinos and Leão, Pedro and Lee, Jae Gil and Leon, Miguel and Lizarazu Pérez, Aintzane and Lohsiriwat, Varut and López-Tomassetti Fernandez, Eudaldo and Lostoridis, Eftychios and Mn, Raghuveer and Major, Piotr and Marinis, Athanasios and Marrelli, Daniele and Martinez-Perez, Aleix and Marwah, Sanjay and McFarlane, Michael and Melo, Renato Bessa and Mesina, Cristian and Michalopoulos, Nick and Moldovanu, Radu and Mouaqit, Ouadii and Munyika, Akutu and Negoi, Ionut and Nikolopoulos, Ioannis and Nita, Gabriela Elisa and Olaoye, Iyiade and Omari, Abdelkarim and Ossa, Paola Rodríguez and Ozkan, Zeynep and Padmakumar, Ramakrishnapillai and Pata, Francesco and Pereira Junior, Gerson Alves and Pereira, Jorge and Pintar, Tadeja and Pouggouras, Konstantinos and Prabhu, Vinod and Rausei, Stefano and Rems, Miran and Rios-Cruz, Daniel and Sakakushev, Boris and Sánchez de Molina, Maria Luisa and Seretis, Charampolos and Shelat, Vishal and Simões, Romeo Lages and Sinibaldi, Giovanni and Skrovina, Matej and Smirnov, Dmitry and Spyropoulos, Charalampos and Tepp, Jaan and Tezcaner, Tugan and Tolonen, Matti and Torba, Myftar and Ulrych, Jan and Uzunoglu, Mustafa Yener and van Dellen, David and van Ramshorst, Gabrielle H. and Vasquez, Giorgio and Venara, Aurélien and Vereczkei, Andras and Vettoretto, Nereo and Vlad, Nutu and Yadav, Sanjay Kumar and Yilmaz, Tonguç Utku and Yuan, Kuo-Ching and Zachariah, Sanoop Koshy and Zida, Maurice and Zilinskas, Justas and Ansaloni, Luca (2015) Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study). World Journal of Emergency Surgery, 10. p. 61. ISSN 1749-7922

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Abstract

BACKGROUND: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. ----- METHODS: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. ----- RESULTS: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. ----- CONCLUSIONS: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

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