New online tool predicts risks for sepsis survivors
A new online tool, funded by NIHR, has been developed to predict the risk of adult survivors of sepsis being readmitted to hospital or dying in the first year after leaving hospital.
It is hoped the tool could help inform patient care pathways to prevent unplanned readmissions to hospital and excess deaths, and is particularly timely because the winter months are associated with an increase in sepsis admissions to hospital.
Sepsis occurs when the body’s immune system goes into overdrive in response to an infection and can lead to multiple organ failure and death.
Sepsis survivors are at an increased risk of adverse events such as unplanned rehospitalisation (in 40% of sepsis survivors) and death (in 15% of sepsis survivors). In the first year after leaving hospital the risk is highest, but sepsis survivors do not currently receive consistent follow-up care to tackle these risks.
The tool has been developed by Dr Manu Shankar-Hari, an NIHR Clinician Scientist and a consultant in intensive care medicine at Guy’s and St Thomas’.
The tool was developed using data from 94,748 patients. The team determined eight factors which affected risk for sepsis survivors: previous hospitalisations in the preceding year, age, socioeconomic status, pre-existing dependency (refers to how much support was required prior to hospitalisation for activities of daily living such as washing and dressing), numbers of pre-existing conditions, admission type, site of infection and admission blood haemoglobin level. Using these, they developed a statistical model that could give an overall risk score for rehospitalisation or death in the first year after leaving hospital.
Dr Shankar-Hari said, “We provide a simple and free online tool for use. Our vision is that by providing health care professionals and sepsis survivors a simple ‘score’ to explicitly understand risk, it may help improve follow-up care of sepsis survivors. The score could inform how to develop clinical pathways and support sepsis survivors’ choices around their ongoing care.
“Looking ahead, we hope that this online tool will help to reduce unplanned rehospitalisation and death after surviving sepsis by informing clinical trials, through better stratification of risk and evidence-based care of sepsis survivors.”
The tool is supported by the Intensive Care National Audit & Research Centre (ICNARC) and has been reviewed and endorsed by the Intensive Care Society. It was developed and validated using anonymised data from around 120,000 sepsis patients from the ICNARC national database for critical care units across England.
This work was funded by an NIHR Clinician Scientist Award. This is a post-doctoral research training award that provides individuals with five years of funding to develop a substantial piece of research in a combined clinical academic role. It has now been replaced by NIHR Advanced Fellowships.
Read the full research paper published in JAMA, ‘Development, validation and clinical utility assessment of a prognostic score for one-year unplanned rehospitalization or death in adult sepsis survivors’. The tool can be found at https://sepsis-ssip-score.org.uk.