Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

World Journal of Emergency Surgery, Dec 2015

Background To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18–99) were enrolled in the WISS study. Results Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. Conclusions WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

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Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Sartelli et al. World Journal of Emergency Surgery Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study) Massimo Sartelli 1 2 3 4 5 6 7 8 Fikri M. Abu-Zidan 1 2 3 4 5 6 7 30 Fausto Catena 1 2 3 4 5 6 7 28 Ewen A. Griffiths 1 2 3 4 5 6 7 35 Salomone Di Saverio 1 2 3 4 5 6 7 34 Raul Coimbra 1 2 3 4 5 6 7 33 Carlos A. Ordoñez 1 2 3 4 5 6 7 10 32 Ari Leppaniemi 1 2 3 4 5 6 7 13 37 Gustavo P. Fraga 1 2 3 4 5 6 7 12 36 Federico Coccolini 1 2 3 4 5 6 7 31 Ferdinando Agresta 1 2 3 4 5 6 7 25 Asrhaf Abbas 1 2 3 4 5 6 7 26 Saleh Abdel Kader 1 2 3 4 5 6 7 23 John Agboola 1 2 3 4 5 6 7 24 Adamu Amhed 1 2 3 4 5 6 7 21 Adesina Ajibade 1 2 3 4 5 6 7 22 Seckin Akkucuk 1 2 3 4 5 6 7 17 Bandar Alharthi 1 2 3 4 5 6 7 19 Dimitrios Anyfantakis 1 2 3 4 5 6 7 15 Goran Augustin 1 2 3 4 5 6 7 29 Gianluca Baiocchi 1 2 3 4 5 6 7 27 Miklosh Bala 1 2 3 4 5 6 7 16 Oussama Baraket 1 2 3 4 5 6 7 18 Savas Bayrak 1 2 3 4 5 6 7 20 Giovanni Bellanova 1 2 3 4 5 6 7 Marcelo A. Beltràn 1 2 3 4 5 6 7 Roberto Bini 1 2 3 4 5 6 7 Matthew Boal 1 2 3 4 5 6 7 35 Andrey V. Borodach 1 2 3 4 5 6 7 Konstantinos Bouliaris 1 2 3 4 5 6 7 Frederic Branger 1 2 3 4 5 6 7 9 Daniele Brunelli 1 2 3 4 5 6 7 Marco Catani 1 2 3 4 5 6 7 Asri Che Jusoh 1 2 3 4 5 6 7 Alain Chichom-Mefire 1 2 3 4 5 6 7 Gianfranco Cocorullo 1 2 3 4 5 6 7 Elif Colak 1 2 3 4 5 6 7 David Costa 1 2 3 4 5 6 7 Silvia Costa 1 2 3 4 5 6 7 Yunfeng Cui 1 2 3 4 5 6 7 Geanina Loredana Curca 1 2 3 4 5 6 7 Terry Curry 1 2 3 4 5 6 7 33 Koray Das 1 2 3 4 5 6 7 Samir Delibegovic 1 2 3 4 5 6 7 Zaza Demetrashvili 1 2 3 4 5 6 7 Isidoro Di Carlo 1 2 3 4 5 6 7 Nadezda Drozdova 1 2 3 4 5 6 7 Tamer El Zalabany 1 2 3 4 5 6 7 Mushira Abdulaziz Enani 1 2 3 4 5 6 7 Mario Faro 1 2 3 4 5 6 7 Mahir Gachabayov 1 2 3 4 5 6 7 Teresa Giménez Maurel 1 2 3 4 5 6 7 Georgios Gkiokas 1 2 3 4 5 6 7 Carlos Augusto Gomes 1 2 3 4 5 6 7 Ricardo Alessandro Teixeira Gonsaga 1 2 3 4 5 6 7 Gianluca Guercioni 1 2 3 4 5 6 7 Ali Guner 1 2 3 4 5 6 7 Sanjay Gupta 1 2 3 4 5 6 7 Sandra Gutierrez 1 2 3 4 5 6 7 Martin Hutan 1 2 3 4 5 6 7 Orestis Ioannidis 1 2 3 4 5 6 7 Arda Isik 1 2 3 4 5 6 7 Yoshimitsu Izawa 1 2 3 4 5 6 7 Sumita A. Jain 1 2 3 4 5 6 7 Mantas Jokubauskas 1 2 3 4 5 6 7 Aleksandar Karamarkovic 1 2 3 4 5 6 7 Saila Kauhanen 1 2 3 4 5 6 7 Robin Kaushik 1 2 3 4 5 6 7 Jakub Kenig 1 2 3 4 5 6 7 Vladimir Khokha 1 2 3 4 5 6 7 Jae Il Kim 1 2 3 4 5 6 7 Victor Kong 1 2 3 4 5 6 7 Renol Koshy 1 2 3 4 5 6 7 Avidyl Krasniqi 1 2 3 4 5 6 7 Ashok Kshirsagar 1 2 3 4 5 6 7 Zygimantas Kuliesius 1 2 3 4 5 6 7 Konstantinos Lasithiotakis 1 2 3 4 5 6 7 Pedro Leão 1 2 3 4 5 6 7 Jae Gil Lee 1 2 3 4 5 6 7 Miguel Leon 1 2 3 4 5 6 7 Aintzane Lizarazu Pérez 1 2 3 4 5 6 7 Varut Lohsiriwat 1 2 3 4 5 6 7 Eudaldo López-Tomassetti Fernandez 1 2 3 4 5 6 7 Eftychios Lostoridis 1 2 3 4 5 6 7 11 Raghuveer Mn 1 2 3 4 5 6 7 Piotr Major 1 2 3 4 5 6 7 Athanasios Marinis 1 2 3 4 5 6 7 Daniele Marrelli 1 2 3 4 5 6 7 Aleix Martinez-Perez 1 2 3 4 5 6 7 Sanjay Marwah 1 2 3 4 5 6 7 Michael McFarlane 1 2 3 4 5 6 7 Renato Bessa Melo 1 2 3 4 5 6 7 Cristian Mesina 1 2 3 4 5 6 7 Nick Michalopoulos 1 2 3 4 5 6 7 Radu Moldovanu 1 2 3 4 5 6 7 Ouadii Mouaqit 1 2 3 4 5 6 7 Akutu Munyika 1 2 3 4 5 6 7 Ionut Negoi 1 2 3 4 5 6 7 Ioannis Nikolopoulos 1 2 3 4 5 6 7 Gabriela Elisa Nita 1 2 3 4 5 6 7 31 Iyiade Olaoye 1 2 3 4 5 6 7 Abdelkarim Omari 1 2 3 4 5 6 7 0 , Ramakrishnapillai Padmakumar 1 Stefano Rausei 2 Gerson Alves Pereira Junior 3 Paola Rodríguez Ossa 4 Tonguç Utku Yilmaz 5 Aurélien Venara 6 Dmitry Smirnov 7 Charampolos Seretis 8 Department of Surgery, Macerata Hospital , Macerata , Italy 9 , Andras Vereczkei 10 , Zeynep Ozkan 11 , Vinod Prabhu 12 , Giovanni Sinibaldi 13 , Myftar Torba 14 , Francesco Pata 15 Primary Health Care Centre of Kissamos , Chania , Greece 16 Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center , Jerusalem , Israel 17 Department of General Surgery, Training and Research Hospital of Mustafa Kemal University , Hatay , Turkey 18 Department of Surgery, Bizerte Hospital , Bizerte , Tunisia 19 Depatment of Surgery, King Fahad Medical City , Riyadh , Saudi Arabia 20 Department of General Surgery, Istanbul Training and Research Hospital 21 Department of Surgery, Ahmadu Bello University Teaching Hospital Zaria , Kaduna , Nigeria 22 Department of Surgery, LAUTECH Teaching Hospital , Osogbo , Nigeria 23 Department of General Surgery, Al Ain Hospital , Al-Ain City , United Arab Emirates 24 Department of Surgery, Kwara State General Hospital , Ilorin , Nigeria 25 General Surgery, ULSS19 del Veneto , Adria, RO , Italy 26 Department of Surgery, Mansoura University Hospital , Mansoura , Egypt 27 Clinical and Experimental Surgery, Brescia Civil Hospital , Brescia , Italy 28 Department of Emergency Surgery, Maggiore Hospital , Parma , Italy 29 Department of Surgery, University Hospital Center , Zagreb , Croatia 30 Department of Surgery, College of Medi (...truncated)


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Massimo Sartelli, Fikri Abu-Zidan, Fausto Catena, Ewen Griffiths, Salomone Di Saverio, Raul Coimbra, Carlos Ordoñez, Ari Leppaniemi, Gustavo Fraga, Federico Coccolini, Ferdinando Agresta, Asrhaf Abbas, Saleh Abdel Kader, John Agboola, Adamu Amhed, Adesina Ajibade, Seckin Akkucuk, Bandar Alharthi, Dimitrios Anyfantakis, Goran Augustin, Gianluca Baiocchi, Miklosh Bala, Oussama Baraket, Savas Bayrak, Giovanni Bellanova, Marcelo Beltràn, Roberto Bini, Matthew Boal, Andrey Borodach, Konstantinos Bouliaris, Frederic Branger, Daniele Brunelli, Marco Catani, Asri Che Jusoh, Alain Chichom-Mefire, Gianfranco Cocorullo, Elif Colak, David Costa, Silvia Costa, Yunfeng Cui, Geanina Curca, Terry Curry, Koray Das, Samir Delibegovic, Zaza Demetrashvili, Isidoro Di Carlo, Nadezda Drozdova, Tamer El Zalabany, Mushira Enani, Mario Faro, Mahir Gachabayov, Teresa Giménez Maurel, Georgios Gkiokas, Carlos Gomes, Ricardo Gonsaga, Gianluca Guercioni, Ali Guner, Sanjay Gupta, Sandra Gutierrez, Martin Hutan, Orestis Ioannidis, Arda Isik, Yoshimitsu Izawa, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Saila Kauhanen, Robin Kaushik, Jakub Kenig, Vladimir Khokha, Jae Kim, Victor Kong, Renol Koshy, Avidyl Krasniqi, Ashok Kshirsagar, Zygimantas Kuliesius, Konstantinos Lasithiotakis, Pedro Leão, Jae Lee, Miguel Leon, Aintzane Lizarazu Pérez, Varut Lohsiriwat, Eudaldo López-Tomassetti Fernandez, Eftychios Lostoridis, Raghuveer Mn, Piotr Major, Athanasios Marinis, Daniele Marrelli, Aleix Martinez-Perez, Sanjay Marwah, Michael McFarlane, Renato Melo, Cristian Mesina, Nick Michalopoulos, Radu Moldovanu, Ouadii Mouaqit, Akutu Munyika, Ionut Negoi, Ioannis Nikolopoulos, Gabriela Nita, Iyiade Olaoye, Abdelkarim Omari, Paola Ossa, Zeynep Ozkan, Ramakrishnapillai Padmakumar, Francesco Pata, Gerson Pereira Junior, Jorge Pereira, Tadeja Pintar, Konstantinos Pouggouras, Vinod Prabhu, Stefano Rausei, Miran Rems, Daniel Rios-Cruz, Boris Sakakushev, Maria Sánchez de Molina, Charampolos Seretis, Vishal Shelat, Romeo Simões, Giovanni Sinibaldi, Matej Skrovina, Dmitry Smirnov, Charalampos Spyropoulos, Jaan Tepp, Tugan Tezcaner, Matti Tolonen, Myftar Torba, Jan Ulrych, Mustafa Uzunoglu, David van Dellen, Gabrielle van Ramshorst, Giorgio Vasquez, Aurélien Venara, Andras Vereczkei, Nereo Vettoretto, Nutu Vlad, Sanjay Yadav, Tonguç Yilmaz, Kuo-Ching Yuan, Sanoop Zachariah, Maurice Zida, Justas Zilinskas, Luca Ansaloni. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study), World Journal of Emergency Surgery, 2015, pp. 61, 10, DOI: 10.1186/s13017-015-0055-0