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Derivation and validation of a screening tool for stroke-associated sepsis

BACKGROUND: Post-stroke infections may cause sepsis, which is associated with poor clinical outcome. Sepsis is defined by life-threatening organ dysfunction that can be identified using the Sequential Organ Failure Assessment (SOFA) score. The applicability of the SOFA score for patients not treated...

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Autores principales: Stösser, Sebastian, Kleusch, Lisa, Schenk, Alina, Schmid, Matthias, Petzold, Gabor C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10339529/
https://www.ncbi.nlm.nih.gov/pubmed/37438794
http://dx.doi.org/10.1186/s42466-023-00258-4
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author Stösser, Sebastian
Kleusch, Lisa
Schenk, Alina
Schmid, Matthias
Petzold, Gabor C.
author_facet Stösser, Sebastian
Kleusch, Lisa
Schenk, Alina
Schmid, Matthias
Petzold, Gabor C.
author_sort Stösser, Sebastian
collection PubMed
description BACKGROUND: Post-stroke infections may cause sepsis, which is associated with poor clinical outcome. Sepsis is defined by life-threatening organ dysfunction that can be identified using the Sequential Organ Failure Assessment (SOFA) score. The applicability of the SOFA score for patients not treated on an intensive care unit (ICU) is limited. The aim of this study was to develop and validate an easier-to-use modification of the SOFA score for stroke patients. METHODS: Using a registry-based cohort of 212 patients with large vessel occlusion stroke and infection, potential predictors of a poor outcome indicating sepsis were assessed by logistic regression. The derived score was validated on a separate cohort of 391 patients with ischemic stroke and infection admitted to our hospital over a period of 1.5 years. RESULTS: The derived Stroke-SOFA (S-SOFA) score included the following predictors: National Institutes of Health stroke scale ≥ 14, peripheral oxygen saturation < 90%, mean arterial pressure < 70 mmHg, thrombocyte count < 150 10(9)/l and creatinine ≥ 1.2 mg/dl. The area under the receiver operating curve for the prediction of a poor outcome indicating sepsis was 0.713 [95% confidence interval: 0.665–0.762] for the S-SOFA score, which was comparable to the standard SOFA score (0.750 [0.703–0.798]), but the prespecified criteria for non-inferiority were not met (p = 0.115). However, the S-SOFA score was non-inferior compared to the SOFA score in non-ICU patients (p = 0.013). CONCLUSIONS: The derived S-SOFA score may be useful to identify non-ICU patients with stroke-associated sepsis who have a high risk of a poor outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42466-023-00258-4.
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spelling pubmed-103395292023-07-14 Derivation and validation of a screening tool for stroke-associated sepsis Stösser, Sebastian Kleusch, Lisa Schenk, Alina Schmid, Matthias Petzold, Gabor C. Neurol Res Pract Research Article BACKGROUND: Post-stroke infections may cause sepsis, which is associated with poor clinical outcome. Sepsis is defined by life-threatening organ dysfunction that can be identified using the Sequential Organ Failure Assessment (SOFA) score. The applicability of the SOFA score for patients not treated on an intensive care unit (ICU) is limited. The aim of this study was to develop and validate an easier-to-use modification of the SOFA score for stroke patients. METHODS: Using a registry-based cohort of 212 patients with large vessel occlusion stroke and infection, potential predictors of a poor outcome indicating sepsis were assessed by logistic regression. The derived score was validated on a separate cohort of 391 patients with ischemic stroke and infection admitted to our hospital over a period of 1.5 years. RESULTS: The derived Stroke-SOFA (S-SOFA) score included the following predictors: National Institutes of Health stroke scale ≥ 14, peripheral oxygen saturation < 90%, mean arterial pressure < 70 mmHg, thrombocyte count < 150 10(9)/l and creatinine ≥ 1.2 mg/dl. The area under the receiver operating curve for the prediction of a poor outcome indicating sepsis was 0.713 [95% confidence interval: 0.665–0.762] for the S-SOFA score, which was comparable to the standard SOFA score (0.750 [0.703–0.798]), but the prespecified criteria for non-inferiority were not met (p = 0.115). However, the S-SOFA score was non-inferior compared to the SOFA score in non-ICU patients (p = 0.013). CONCLUSIONS: The derived S-SOFA score may be useful to identify non-ICU patients with stroke-associated sepsis who have a high risk of a poor outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42466-023-00258-4. BioMed Central 2023-07-13 /pmc/articles/PMC10339529/ /pubmed/37438794 http://dx.doi.org/10.1186/s42466-023-00258-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Stösser, Sebastian
Kleusch, Lisa
Schenk, Alina
Schmid, Matthias
Petzold, Gabor C.
Derivation and validation of a screening tool for stroke-associated sepsis
title Derivation and validation of a screening tool for stroke-associated sepsis
title_full Derivation and validation of a screening tool for stroke-associated sepsis
title_fullStr Derivation and validation of a screening tool for stroke-associated sepsis
title_full_unstemmed Derivation and validation of a screening tool for stroke-associated sepsis
title_short Derivation and validation of a screening tool for stroke-associated sepsis
title_sort derivation and validation of a screening tool for stroke-associated sepsis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10339529/
https://www.ncbi.nlm.nih.gov/pubmed/37438794
http://dx.doi.org/10.1186/s42466-023-00258-4
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