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| The values of Howell - PIRO model in predicting in - hospital mortality for patients with severe sepsis or septic shock |
| WANG Xiao - qian, ZHANG Hong |
| Department of Emergency, the First Affiliated Hospital of Medical University of Anhui, Hefei 230022, China |
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Abstract Objective To investigate the values of the Howell - PIRO ( predisposition, infection,response, organ dysfunction) model in predicting the in - hospital mortality of severe sepsis or septic shock patients in the Emergency Intensive Care Unit (EICU). Methods Clinical data of patients admitted to EICU of the First Affiliated Hospital of Anhui Medical University from June 2012 to June 2013 were retrospectively researched. APACHE Ⅱ, Howell - PIRO and SOFA scores were respectively calculated from EICU data. Areas under the receiver operator characteristic (ROC) curves for 28 - day prognosis were compared. Results A total of 123 enrolled patients, severe sepsis group was 102 (83% ), septic shock group was 21 (17% ). Compared with the two groups: there were significant differences in Howell - PIRO scores(16 ± 3)vs. (19 ± 3) and SOFA scores(7 ± 3)vs. (10 ± 3)(P < 0．05),but it was no obvious difference in APACHEⅡ scores(20 ± 8)vs. (24 ± 9)(P = 0. 058). ROC curve drawing according to the prognosis of 28 - day: the area under the curve of Howell - PIRO scores was 0. 816(95% CI 0. 736 to 0. 880), the sensitivity was 81. 40% , specificity was 64. 86% , the best cut - off values was 17(P < 0. 0001); the area under the curve of APACHEⅡ scores was 0. 703(95% CI 0. 614 to 0. 782),the sensitivity was 88. 37% , specificity was 49. 95% , the best cut - off values was 27(P = 0. 0001);the area under the curve of SOFA scores was 0. 802(95% CI 0. 721 to 0. 869),the sensitivity was 68. 60% , specificity was 81. 80% , the best cut - off values was 7 ( P < 0. 0001); There were no obvious differences in pairwise comparisons of the three scores(P > 0. 05). The patients was divided into surviving group (86 cases) and death group (37 cases) according to the 28 days’ prognosis,thirty - seven (30% ) patients died within 28 days of presentation; The three systems were significant differences in two groups of contrast(P < 0. 05). Conclusion Comparison of PIRO score with other scoring systems, the Howell - PIRO score is better to predict mortality in EICU patients with severe sepsis and septic shock. And the sensitivity is superior to SOFA score,specificity is superior to APACHEⅡ score.
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Received: 30 September 2015
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Corresponding Authors:
ZHANG Hong, E - mail: zhanghong20070703@ 163. com
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Address: 1 North 2nd Street,
Zhongguancun, 
