Development and external validation of a 90-day mortality prediction model for comatose sepsis patients: impact of cerebrovascular disease and dementia - Report - MDSpire
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Creation and external assessment of a mortality prediction model for comatose sepsis patients over 90 days: the role of cerebrovascular disorders and dementia
Clinical Report: Mortality Prediction Model for Comatose Sepsis Patients
Overview
This study developed a 90-day mortality prediction model for comatose sepsis patients, identifying cerebrovascular disease and dementia as significant predictors.
Background
Comatose sepsis patients are at a heightened risk of mortality, yet the long-term prognostic factors influencing their outcomes remain inadequately defined. Understanding how neurological comorbidities, such as cerebrovascular disorders and dementia, affect mortality risk is crucial.
Data Highlights
Variable
Odds Ratio (OR)
Age
1.05
Base Excess
0.85
PaO2 (per 10-unit decrease)
1.04
BUN
1.02
INR
3.68
Cerebrovascular Disease
2.60
Dementia
4.64
Key Findings
Ninety-day mortality rate was 22.83% among comatose sepsis patients.
Cerebrovascular disease and dementia were identified as strong independent risk factors for mortality.
Glasgow Coma Scale (GCS) was not a significant independent predictor in the final model.
Lower GCS scores correlated with higher mortality in patients without cerebrovascular disease or dementia.
The model achieved a C-index of 0.81, outperforming SOFA, APACHE II, and SAPS II.
External validation confirmed good transportability with a C-index of 0.75.
Clinical Implications
The findings highlight the importance of considering neurological comorbidities when assessing mortality risk in comatose sepsis patients.
Conclusion
Cerebrovascular disease and dementia are strong predictors of 90-day mortality and significantly modulate GCS prognostic value.