Integration of metabolic parameters with SOFA score for mortality risk assessment in elderly sepsis: a derivation study.

ABSTRACT:

Background

Sepsis mortality remains elevated among elderly populations, yet existing risk stratification tools demonstrate suboptimal predictive accuracy. We explored whether incorporating metabolic parameters into the Sequential Organ Failure Assessment (SOFA) score could enhance prognostic discrimination in this vulnerable cohort.

Methods

This retrospective cohort study analyzed 4,056 elderly sepsis patients (age ≥ 65 years) admitted to intensive care units between 2008 and 2019, identified through ICD coding from the MIMIC-IV database. Random forest-based feature selection and SHAP value analysis identified lactate and bicarbonate as influential mortality predictors. We constructed three nested logistic regression models: Model 1 (SOFA alone), Model 2 (SOFA plus lactate),

SUBMITTER: Zhu X 

PROVIDER: S-EPMC12625156 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature