Validez de las escalas predictoras de mortalidad en sepsis abdominal

The objective of this study was to determine the validity of mortality prediction scores in abdominal sepsis among patients in the ICU of Vicente Corral Moscoso Hospital, Cuenca, Ecuador. A diagnostic test evaluation study was conducted in which the following scores were applied: SOFA (Sequential Organ Failure Assessment), GCS (Glasgow Coma Scale), SAPS (Simplified Acute Physiology Score), MODS (Multiple Organ Dysfunction Score), LODS (Logistic Organ Dysfunction Score), and MPM (Mortality Probability Model), using the APACHE II (Acute Physiology And Chronic Health Evaluation) score as the reference standard. The study population included 155 patients diagnosed with abdominal sepsis. To determine test validity, ROC curve analysis, sensitivity, specificity, positive and negative predictive values, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were used. The mean patient age was 60 years (SD ± 19 years), with the predominant group being elderly females (51%). The most frequent comorbidities were arterial hypertension (34.2%) and diabetes mellitus (20.6%). The most common postoperative complication was pneumonia (25.8%), and the most frequent cause of sepsis was cholangitis (26.5%). The LODS score achieved the highest area under the curve (0.96) with 96% sensitivity and 82% specificity, while SOFA showed the lowest sensitivity (78%) and specificity (71%). In conclusion, the LODS score demonstrated the highest validity in predicting mortality from abdominal sepsis when compared with SOFA, GCS, SAPS, MODS, and MPM.