Comparison of scoring systems of sepsis for predicting 28-day mortality in Egyptian ICU sepsis patients based on sepsis 3 criteria

Abotaleb, Aliaa Shebl; Negm, Osama El-Sayed; Abdelkhalik, Sameh; El-sharawy, Shimaa Mahmoud

doi:10.21608/mid.2025.364338.2583

	Comparison of scoring systems of sepsis for predicting 28-day mortality in Egyptian ICU sepsis patients based on sepsis 3 criteria
Microbes and Infectious Diseases
Articles in Press, Accepted Manuscript, Available Online from 28 March 2025
Document Type: Original Article
DOI: 10.21608/mid.2025.364338.2583
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Authors
Aliaa Shebl Abotaleb¹; Osama El-Sayed Negm¹; Sameh Abdelkhalik²; Shimaa Mahmoud El-sharawy ¹
¹Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Egypt
²Anesthesiology, Surgical Intensive Care Department, Faculty of Medicine, Tanta University, Egypt.
Abstract
Background: Sepsis has emerged as a major global public health concern. The purpose of this study was to determine the risk factors associated with the incidence of death among 5 common models (SOFA, APACHE II, LODS, SAPS II, and SAPS III) and reevaluate their discrimination in predicting the 28-day mortality of ICU Egyptian patients. Methods: A prospective cohort study was carried out from July 2023 to August 2024 on 100 ICU patients who were diagnosed with sepsis either at admission or later. The study was carried out in various ICUs, including the medical and surgical ICUs of Tanta University Hospitals. The 28-day mortality outcome was documented, and the various mortality scores were calculated. Results: The mortality rate was 61%, and the most common infections among nonsurvivors were intraabdominal (27.2%) and respiratory tract (23%). GCS, SBP, TLC, platelets, PH, bicarbonate, Fio2, AST, total bilirubin, PT, creatinine, urine output, serum lactate, procalcitonin, mechanical ventilation, and need for vasoactive therapy were significant predictors for sepsis outcomes (p < 0.005). Additionally, models for predicting mortality that were significant (p < 0.005) included SOFA, APACHE II, LODS, SAPS II, and SAPS III. At a cutoff of >4, the SOFA score demonstrated the highest AUC of 0.850 with sensitivity (86.89) and specificity (66.67). The SAPS III score was an independent predictor of the 28-day mortality rate among patients with ICU sepsis in multivariate regression analysis. Conclusion: Combining the SOFA and SAPS III scores is expected to improve overall outcomes, lower expenses, and improve prognosis in ICUs.
Keywords
Sepsis; Intensive care units; Mortality Scores; Predictors; Egypt


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