Utility of World Society of Emergency Surgery Sepsis Severity Score in Predicting Outcomes of Intra-abdominal Infections

Abstract

Background: Intra-abdominal infections are classified as simple or complicated. Many tools have been studied to predict risk factors and outcomes of patients with intra-abdominal infections. None of these tools has been adopted for patient care at the Kenyatta National Hospital (KNH), Kenya.

Objective: To determine the utility of the World Society of Emergency Surgery (WSES) Sepsis Severity Score in predicting short-term outcomes of patients managed for complicated intra-abdominal infections.

Methods: We conducted a hospital-based prospective cohort study. Patients aged 18 years and above with complicated intra-abdominal infections were recruited. Data were obtained on demographics, condition at admission, time to source control, origin of infection, immune suppressants and complications. IBM SPSS version 21.0 was used to obtain means and standard deviations while logistic regression was used for associations.

Results: A sepsis severity score of 6.5, best predicted mortality having a sensitivity of 80% and a specificity of 20.9% were obtained. For each unit increase in the WSES scores, the odds of mortality were 2.1, organ dysfunction 2.2, CCU admission 2.1.

Conclusion: Our sepsis severity score has demonstrated good performance in our adult population, and also ability to predict adverse outcomes other than mortality in patients managed for intra-abdominal sepsis.

Keywords: WSES, Sepsis, Sepsis severity score, Intra-abdominal infections