Prediction of Mortality in Patients with Sepsis Due to Gram-negative Bacteremia: Pitt Bacteremia Score, qSOFA, SIRS

Abstract

Introduction: Sepsis is a syndrome of physiologic, biochemical and pathologic abnormalities induced by infection and has been associated with high mortality and morbidity. This study aimed to compare Systemic Inflammatory Response Syndrome (SIRS) criteria, Pitt bacteremia score and quick Sequential Organ Failure Assessment (qSOFA) for the prediction of mortality in patients with sepsis due to Gram-negative bacteremia. Materials and Methods: Patients with sepsis due to Gram-negative bacteremia admitted to emergency medicine clinic were observed retrospectively from March 2016 to March 2018. Clinical data, laboratory results, co-morbidities, antimicrobial treatment, Pitt bacteremia score, qSOFA score, SIRS criteria of patients were evaluated. Results: A total of 106 patients with sepsis due to gram-negative bacteremia according to Sepsis-2 definition were included. Thirty-day mortality was 20.8\%. Multivariate analysis determined Pitt bacteraemia score (OR:1.63, 95\% CI 1.29-2.05, p< 0.001) as predictors of mortality among septic patients. The area under the ROC curve was 0.885 (95\% CI 0.737-0.933) for Pitt bacteremia score 0.808 (95\% CI 0.713-0.904) for qSOFA and 0.623 (95\% CI 0.492-0.753) for SIRS. Pitt bacteremia score showed the highest specificity (\%71.4) and positive predictive value (\%40.0) as compared to other scores. Conclusion: As the result of the analyses, the mortality rate in patients with sepsis due to gram-negative bacteremia was better predicted with the Pitt bacteremia score than qSOFA score and SIRS criteria.