ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1574625
This article is part of the Research TopicMolecular mechanisms and clinical studies of multi-organ dysfunction in sepsis associated with pathogenic microbial infectionView all 19 articles
The Predictive Value of SOFA and APSIII Scores for 28-Day Mortality Risk in SIMI: A Cohort Study Based on the MIMIC-IV Database
Provisionally accepted
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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The objective of this study was to systematically identify and evaluate scoring systems that predict the prognosis of patients with sepsis-induced myocardial injury (SIMI). Methods: Data were retrieved from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Logistic and Cox regression analyses were conducted to identify risk factors associated with 28-day mortality in patients with sepsis-induced myocardial injury (SIMI). The prognostic performance of the scoring systems was comprehensively assessed using receiver operating characteristic (ROC) curves, Kaplan-Meier survival and decision curve analysis (DCA). Results: Logistic regression analysis showed that Acute Physiology Score III (APSIII) (Odds Ratio [OR] =1.011, 95% Confidence Interval [CI] 1.002-1.018, P=0.005), Sequential Organ Failure Assessment (SOFA) (OR =1.097, 95% CI 1.045-1.144, P<0.001), and Charlson Comorbidity Index (CHARLSON) (OR=1.095, 95% CI 1.048-1.145, P=0.036) were independent risk factors for 28-day mortality in SIMI patients. Cox regression analysis confirmed that SOFA (HR=1.082, 95% CI 1.054-1.111, P<0.001), APSIII (HR=1.010, 95% CI 1.005-1.015, P<0.001), and CHARLSON (HR=1.044, 95% CI 1.012-1.077, P=0.007) were independent risk factors. ROC curve analysis showed that SOFA (AUC=0.685, 95% CI 0.663-0.707) and APSIII (AUC=0.683, 95% CI 0.662-0.705) had significantly higher AUC values compared to other scoring systems. DCA results showed that APSIII and SOFA had better net benefit than other scoring systems. Conclusions: The SOFA and APSIII scores effectively identified high-risk patients with SIMI, providing evidence-based support for early clinical intervention.
Keywords: Sepsis, Sepsis-induced myocardial injury (SIMI), SOFA score, APSIII score, mortality risk, MIMIC-IV database
Received: 11 Feb 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Liu, Wang, 刘 and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Min Cao, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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