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A novel id-iri score: development and internal validation of the multivariable community acquired sepsis clinical risk prediction model

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Abstract

We aimed to develop a scoring system for predicting in-hospital mortality of community-acquired (CA) sepsis patients. This was a prospective, observational multicenter study performed to analyze CA sepsis among adult patients through ID-IRI (Infectious Diseases International Research Initiative) at 32 centers in 10 countries between December 1, 2015, and May 15, 2016. After baseline evaluation, we used univariate analysis at the second and logistic regression analysis at the third phase. In this prospective observational study, data of 373 cases with CA sepsis or septic shock were submitted from 32 referral centers in 10 countries. The median age was 68 (51–77) years, and 174 (46,6%) of the patients were females. The median hospitalization time of the patients was 15 (10–21) days. Overall mortality rate due to CA sepsis was 17.7% (n = 66). The possible predictors which have strong correlation and the variables that cause collinearity are acute oliguria, altered consciousness, persistent hypotension, fever, serum creatinine, age, and serum total protein. CAS (%) is a new scoring system and works in accordance with the parameters in third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The system has yielded successful results in terms of predicting mortality in CA sepsis patients.

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Authors and Affiliations

  1. Department of Infectious Diseases and Clinical Microbiology, Şişli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey

    Husrev Diktas

  2. Department of Infectious Diseases and Clinical Microbiology, Kanuni Research and Training Hospital, Trabzon, Turkey

    Serhat Uysal

  3. Department of Infectious Diseases and Clinical Microbiology, Gulhane Research and Training Hospital, Ankara, Turkey

    Hakan Erdem

  4. Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey

    Yasemin Cag, Fatma Yilmaz-Karadag & Pinar Ergen

  5. Department of Infectious Diseases, Sf. Parascheva Infectious Diseases Clinical Hospital, Iasi, Romania

    Egidia Miftode

  6. Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey

    Gul Durmus

  7. Department of Infectious Disease and Clinical Microbiology, Erciyes University Medical School, Kayseri, Turkey

    Ayşegul Ulu-Kilic & Selma Alabay

  8. Joined St. Stephan and St. Ladislaus Hospital-Clinic, Budapest, Hungary

    Balint Gergely Szabo & Botond Lakatos

  9. Department of Pulmonary and Critical Care, San Juan City Hospital, San Juan, Puerto Rico

    Ricardo Fernandez & Michael Cruz Caliz

  10. Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Dumlupınar University, Kutahya, Turkey

    Pinar Korkmaz

  11. Service des Maladies Infectieuses et Tropicales, Hôpitaux Universitaires, Strasbourg, France

    Xavier Argemi

  12. Department of Infectious Diseases and Epidemiology, Medical University Astana, Astana, Kazakhstan

    Sholpan Kulzhanova

  13. Department of Infectious Diseases and Clinical Microbiology, Konya Training and Research Hospital, Konya, Turkey

    Fatime Kormaz

  14. Department of Infectious Diseases and Clinical Microbiology, Samsun Research and Training Hospital, Samsun, Turkey

    Aynur Atilla

  15. University Hospital Center, Tirana, Albania

    Edmond Puca

  16. Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Turkey

    Mustafa Dogan

  17. Diagnostics and Public Health, Policlinico GB Rossi-Verona, Verona, Italy

    Francesca Mangani

  18. Department of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey

    Suzan Sahin & Ayşe Batirel

  19. Clinic for Infectious Diseases, University Clinical Hospital Mostar, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina

    Svjetlana Grgić

  20. Department of Intensive Care, University Clinic for Infectious Diseases, Skopje, Macedonia

    Krsto Grozdanovski

  21. Department of Infectious Diseases and Clinical Microbiology, Ankara Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey

    Gul Ruhsar Yilmaz

  22. Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Garibaldi Nesima Hospital, Catania, Italy

    Rosa Fontana Del-Vecchio

  23. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey

    Aslihan Demirel

  24. Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey

    Fatma Sirmatel

  25. Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey

    Alper Şener & Suzan Sacar

  26. Department of Infectious Diseases and Clinical Microbiology, Kafkas University School of Medicine, Kars, Turkey

    Emsal Aydin

  27. Centre of Disease Prevention and Control, Institute of Public Health of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

    Gorana Dragovac

  28. Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Rehab El-Sokkary

  29. Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania

    Crişan Alexandru

  30. Department of Infectious Diseases and Clinical Microbiology, Derince Training Hospital, Kocaeli, Turkey

    Selcan Arslan-Ozel

  31. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Sibel Bolukcu

  32. Department of Infectious Diseases and Clinical Microbiology, Cigli Regional Education Hospital, Izmir, Turkey

    H. Deniz Ozkaya

  33. Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey

    Saygin Nayman-Alpat

  34. Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey

    Asuman Inan

  35. Department of Medicine, Infectious Diseases Division, King Saud University Hospital, Riyadh, Saudi Arabia

    Fahad Al-majid

  36. Department of Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep, Turkey

    Berna Kaya-Ugur

  37. Critical Care Department, Hospital Vall d’Hebron, Ciberes, Universitat Autonma de Barcelona, Barcelona, Spain

    Jordi Rello

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  1. Husrev Diktas
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  2. Serhat Uysal
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  3. Hakan Erdem
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  4. Yasemin Cag
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  5. Egidia Miftode
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  6. Gul Durmus
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  7. Ayşegul Ulu-Kilic
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  8. Selma Alabay
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  9. Balint Gergely Szabo
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  10. Botond Lakatos
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  11. Ricardo Fernandez
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  12. Pinar Korkmaz
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  13. Michael Cruz Caliz
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  14. Xavier Argemi
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  15. Sholpan Kulzhanova
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  19. Aynur Atilla
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  20. Edmond Puca
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  21. Mustafa Dogan
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  22. Francesca Mangani
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  23. Suzan Sahin
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  24. Svjetlana Grgić
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  25. Krsto Grozdanovski
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  26. Gul Ruhsar Yilmaz
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  27. Rosa Fontana Del-Vecchio
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  28. Aslihan Demirel
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  29. Fatma Sirmatel
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  30. Alper Şener
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  31. Suzan Sacar
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  32. Emsal Aydin
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  33. Ayşe Batirel
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  34. Gorana Dragovac
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  35. Rehab El-Sokkary
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  36. Crişan Alexandru
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  37. Selcan Arslan-Ozel
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  38. Sibel Bolukcu
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  39. H. Deniz Ozkaya
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  40. Saygin Nayman-Alpat
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  41. Asuman Inan
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  42. Fahad Al-majid
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  43. Berna Kaya-Ugur
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  44. Jordi Rello
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Corresponding author

Correspondence to Hakan Erdem.

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Diktas, H., Uysal, S., Erdem, H. et al. A novel id-iri score: development and internal validation of the multivariable community acquired sepsis clinical risk prediction model. Eur J Clin Microbiol Infect Dis 39, 689–701 (2020). https://doi.org/10.1007/s10096-019-03781-y

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