Objective:

To evaluate the predictive performance of the Vasoactive-Age adjusted SIC (VAS) score for new-onset multiple organ dysfunction syndrome (MODS) in sepsis patients.

Approach:

• Study Design: Single-centre retrospective cohort study enrolling 495 adult sepsis patients from January 2019 to June 2023.
• Outcome Measures: Primary outcome was 28-day new-onset MODS; predictive performance compared using AUC and multivariable Cox regression.
• Statistical Analysis: Cumulative incidence estimated with Fine–Gray models; NRI, IDI, and decision curve analysis quantified incremental value.

Key Findings:

• New-onset MODS occurred in 148 patients (29.9%).
• VAS score AUC was 0.777 [95% CI 0.755–0.841], significantly higher than SIC (0.708, p < 0.001) and qSOFA (0.671, p < 0.001).
• VAS ≥ 4 had 76.4% sensitivity and 73.2% specificity.
• VAS ≥ 4 was independently predictive of MODS (HR 3.42 [95% CI 2.31–5.07], p < 0.001).
• Dynamic VAS increase (ΔVAS>0) over 48 h was associated with a 4.78-fold higher MODS risk (p < 0.001).

Interpretation:

Limitations:

• Single-centre study may limit generalizability.
• Retrospective design may introduce bias.

Conclusion: