Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study

Objective: To develop and validate a scoring system to predict the risk of in-hospital death in patients with intra-abdominal infection (IAI).Materials and Methods: Patients with IAI (n = 417) treated at our hospital between June 2010 and May 2020 were retrospectively reviewed. Risk factors for in-h...

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Autores principales:	Gaici Xue, Hongyi Liang, Jiasheng Ye, Jingjing Ji, Jianyu Chen, Bo Ji, Zhifeng Liu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	intra-abdominal infection in-hospital death risk factors predictive scoring system bootstrapping sample Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/ee05cbbc40fa41fda876d177376099aa
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spelling	oai:doaj.org-article:ee05cbbc40fa41fda876d177376099aa2021-11-12T06:07:17ZDevelopment and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study2296-858X10.3389/fmed.2021.741914https://doaj.org/article/ee05cbbc40fa41fda876d177376099aa2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.741914/fullhttps://doaj.org/toc/2296-858XObjective: To develop and validate a scoring system to predict the risk of in-hospital death in patients with intra-abdominal infection (IAI).Materials and Methods: Patients with IAI (n = 417) treated at our hospital between June 2010 and May 2020 were retrospectively reviewed. Risk factors for in-hospital death were identified by logistic regression analysis. The regression coefficients of each risk factor were re-assigned using the mathematical transformation principle to establish a convenient predictive scoring system. The scoring system was internally validated by bootstrapping sample method.Results: Fifty-three (53/417, 12.7%) patients died during hospitalization. On logistic regression analysis, high APACHE II score (P = 0.012), pneumonia (P = 0.002), abdominal surgery (P = 0.001), hypoproteinemia (P = 0.025), and chronic renal insufficiency (P = 0.001) were independent risk factors for in-hospital death. On receiver operating characteristic curve analysis, the composite index combining these five risk factors showed a 62.3% sensitivity and 80.2% specificity for predicting in-hospital death (area under the curve: 0.778; 95% confidence interval: 0.711–0.845, P < 0.001). The predictive ability of the composite index was better than that of each independent risk factor. A scoring system (0–14 points) was established by re-assigning each risk factor based on the logistic regression coefficient: APACHE II score (10–15 score, 1 point; >15 score, 4 points); pneumonia (2 points), abdominal surgery (2 points), hypoproteinemia (2 points), and chronic renal insufficiency (4 points). Internal validation by 1,000 bootstrapping sample showed relatively high discriminative ability of the scoring system (C-index = 0.756, 95% confidence interval: 0.753–0.758).Conclusions: The predictive scoring system based on APACHE II score, pneumonia, abdominal surgery, hypoproteinemia, and chronic renal insufficiency can help predict the risk of in-hospital death in patients with IAI.Gaici XueHongyi LiangJiasheng YeJingjing JiJianyu ChenBo JiZhifeng LiuFrontiers Media S.A.articleintra-abdominal infectionin-hospital deathrisk factorspredictive scoring systembootstrapping sampleMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	intra-abdominal infection in-hospital death risk factors predictive scoring system bootstrapping sample Medicine (General) R5-920
spellingShingle	intra-abdominal infection in-hospital death risk factors predictive scoring system bootstrapping sample Medicine (General) R5-920 Gaici Xue Hongyi Liang Jiasheng Ye Jingjing Ji Jianyu Chen Bo Ji Zhifeng Liu Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study
description	Objective: To develop and validate a scoring system to predict the risk of in-hospital death in patients with intra-abdominal infection (IAI).Materials and Methods: Patients with IAI (n = 417) treated at our hospital between June 2010 and May 2020 were retrospectively reviewed. Risk factors for in-hospital death were identified by logistic regression analysis. The regression coefficients of each risk factor were re-assigned using the mathematical transformation principle to establish a convenient predictive scoring system. The scoring system was internally validated by bootstrapping sample method.Results: Fifty-three (53/417, 12.7%) patients died during hospitalization. On logistic regression analysis, high APACHE II score (P = 0.012), pneumonia (P = 0.002), abdominal surgery (P = 0.001), hypoproteinemia (P = 0.025), and chronic renal insufficiency (P = 0.001) were independent risk factors for in-hospital death. On receiver operating characteristic curve analysis, the composite index combining these five risk factors showed a 62.3% sensitivity and 80.2% specificity for predicting in-hospital death (area under the curve: 0.778; 95% confidence interval: 0.711–0.845, P < 0.001). The predictive ability of the composite index was better than that of each independent risk factor. A scoring system (0–14 points) was established by re-assigning each risk factor based on the logistic regression coefficient: APACHE II score (10–15 score, 1 point; >15 score, 4 points); pneumonia (2 points), abdominal surgery (2 points), hypoproteinemia (2 points), and chronic renal insufficiency (4 points). Internal validation by 1,000 bootstrapping sample showed relatively high discriminative ability of the scoring system (C-index = 0.756, 95% confidence interval: 0.753–0.758).Conclusions: The predictive scoring system based on APACHE II score, pneumonia, abdominal surgery, hypoproteinemia, and chronic renal insufficiency can help predict the risk of in-hospital death in patients with IAI.
format	article
author	Gaici Xue Hongyi Liang Jiasheng Ye Jingjing Ji Jianyu Chen Bo Ji Zhifeng Liu
author_facet	Gaici Xue Hongyi Liang Jiasheng Ye Jingjing Ji Jianyu Chen Bo Ji Zhifeng Liu
author_sort	Gaici Xue
title	Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study
title_short	Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study
title_full	Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study
title_fullStr	Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study
title_full_unstemmed	Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study
title_sort	development and validation of a predictive scoring system for in-hospital death in patients with intra-abdominal infection: a single-center 10-year retrospective study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ee05cbbc40fa41fda876d177376099aa
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Development and Validation of a Predictive Scoring System for In-hospital Death in Patients With Intra-Abdominal Infection: A Single-Center 10-Year Retrospective Study

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