Validez de las escalas predictoras de mortalidad en sepsis abdominal. Hospital Vicente Corral Moscoso. Cuenca- Ecuador 2019

Abstract

Objective: to determine the validity of the predictive mortality scales in abdominal sepsis in patients in the ICU area of the Vicente Corral Moscoso Hospital. Cuenca - Ecuador, period 2019. Materials and methods: this is a diagnostic test evaluation study, where various scales were applied such as SOFA (Sequential Organ Failure Assessment); GCS (Glasgow coma scale); SAPS (Simplified Acute Physiology Score), MODS (Multiple Organ Dysfunction Score), LODS (Logistic Organ Dysfunction Score); MPM (Mortality Probability Model). The APACHE II (Acute Physiology And Cronic Health Evaluation) scale was taken as the gold test, the population corresponded to 155 patients diagnosed with abdominal-type sepsis. To determine the validity of the tests, the ROC curve, Sensitivity, Specificity and positive, negative, positive LR, negative LR predictive values were used. Expected results: the average age was 60 years, (SD ± 19 years). The most predominant group were the elderly female (51%). The comorbidities were: arterial hypertension (34.20%) and diabetes mellitus (20.60%). The most frequent postoperative complication was pneumonia (25.80%). The most frequent cause of sepsis was cholangitis (26.50%). The LODS scale obtained an area under the curve of 0.96 with S = 96% and E = 82%; SOFA was the one with the lowest S = 78% and E = 71%. Conclusion: the LODS scale was the one with the highest validity in predicting mortality from abdominal sepsis, when compared with SOFA, GCS, SAPS, MODS, MPM.