A Novel Prediction Prognosis Model of sepsis with acute respiratory failure: A cohort study from the MIMIC-IV database

Objectives: Acute respiratory failure is significantly related to increased short-term mortality in sepsis patients. We aimed to develop a novel prognosis model for predicting the risk for hospital mortality in sepsis patients with acute respiratory failure. Methods: : We researched the Medical Information Mart for Intensive Care (MIMIC)-IV database, and developed a matched cohort of adult sepsis with acute respiratory failure. After applying multivariate Cox regression, a nomogram was developed based on identified risk factors of the mortality in the cohort. Besides, the discrimination of the nomogram in predicting individual hospital death was evaluated by the area under o the characteristic operating curve (ROC). Results: : A total of 663 sepsis patients with acute respiratory failure were included in this study. Systolic blood pressure, white blood cell count, neutrophils, mechanical ventilation, PaO 2 < 60mmHg, abdominal cavity infection, Klebsiella pneumoniae, Acinetobacter baumannii, and immunosuppressive disease were the independent risk predictors of the mortality in sepsis patients with acute respiratory failure. The area under curve of the nomogram in the ROC was 0.880 (95% CI: 0.851-0.908) that provided significantly higher discrimination compared with simplified acute physiology score II [0.656 (95% CI: 0.612-0.701)]. Conclusion: The model has good performance in predicting the mortality risk of sepsis patients with acute respiratory failure, and it can be clinically useful to evaluate the short-term prognosis in critically ill patients with sepsis and acute respiratory failure.