In a retrospective study from Henan Provincial People’s Hospital, researchers reported that the new model outperformed Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) when tested in more than 1,300 patients with sepsis secondary to pneumonia.

Mortality occurred in 49% of the derivation cohort and 45% of the validation cohort. Patients who died within 28 days had higher rates of septic shock, higher white blood cell counts and neutrophil-to-lymphocyte ratios, greater lactate dehydrogenase and D-dimer levels, lower PaO₂/FiO₂ ratios, and more frequent vasoactive drug use compared with survivors.

The study included 1,337 sepsis secondary to pneumonia patients admitted to the respiratory intensive care unit between 2017 and 2022. Median age was about 71 years, most patients were men, and common comorbidities included cardiovascular disease, cerebrovascular disease, and diabetes.

The model used seven admission variables—age, white blood cell count, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, arterial oxygen pressure/fraction of inspired oxygen (PaO₂/FiO₂), D-dimer, and vasoactive drug use. In the derivation cohort of 941 patients, the model achieved an AUC of 0.78, compared with 0.60 for SOFA and 0.63 for APACHE II. In the validation cohort of 396 patients, the AUC was 0.80, compared with 0.66 and 0.69, respectively.

The model is available as a web-based calculator, using standard admission data. Researchers reported that such tools could enable early identification of high-risk patients.

Limitations included the single-center, retrospective design, lack of certain immune markers (e.g., interleukin-6, T-cell subpopulations), and a study population drawn from a tertiary hospital, which may limit generalizability. Prospective multicenter studies are needed to validate the model further.

The authors reported no conflicts of interest.

Source: Frontiers