The value of five scoring systems in predicting the prognosis of patients with sepsis-associated acute respiratory failure.

ABSTRACT

Our study aimed to identify the optimal scoring system for predicting the prognosis of patients with sepsis-associated acute respiratory failure (SA-ARF). All data were taken from the fourth version of the Markets in Intensive Care Medicine (MIMIC-IV) database. Independent risk factors for death in hospitals were confirmed by regression analysis. The predictive value of the five scoring systems was evaluated by receiving operating characteristic (ROC) curves. Kaplan‒Meier curves showed the impact of acute physiology score III (APSIII) on survival and prognosis in patients with SA-ARF. Decision curve analysis (DCA) identified a scoring system with the highest net clinical benefit. ROC curve analysis showed that APS III (AUC 0.755, 95% Cl 0.714-0.768) and Logical Organ Dysfunction System (LODS) (AUC 0.731, 95% Cl 0.717-0.7745) were better than Simplified Acute Physiology Score II (SAPS II) (AUC 0.727, 95% CI 0.713-0.741), Oxford Acute Severity of Illness Score (OASIS) (AUC 0.706, 95% CI 0.691-0.720) and Sequential Organ Failure Assessment (SOFA) (AUC 0.606, 95% CI 0.590-0.621) in assessing in-hospital mortality. Kaplan‒Meier survival analysis patients in the high-APS III score group had a considerably poorer median survival time. The DCA curve showed that APS III may provide better clinical benefits for patients. We demonstrated that the APS III score is an excellent predictor of in-hospital mortality.