A Karnofsky Performance Status-Based Risk Score Improves Prediction of Post-Sepsis Mortality in Sub-Saharan Africa: A...

Area of Science:

• Global Health
• Critical Care Medicine
• Epidemiology

Background:

• Sepsis survivors face high post-discharge mortality, particularly in sub-Saharan Africa.
• Accurate risk stratification is crucial for targeted follow-up care in sepsis survivors.
• Current risk prediction models may not adequately address the needs of low-resource settings.

Purpose of the Study:

• To evaluate the performance of Karnofsky Performance Status (KPS) for predicting post-discharge mortality in adult sepsis survivors in Uganda.
• To determine if KPS improves risk stratification beyond existing clinical variables.
• To inform strategies for improving sepsis survivorship in low- and middle-income countries.

Main Methods:

• Prospective observational study of two cohorts in Entebbe and Tororo, Uganda.
• Adults hospitalized with sepsis were assessed using KPS at discharge.
• Post-discharge mortality was tracked at 30 and 60 days.

Main Results:

• Higher KPS scores at discharge were significantly associated with reduced post-discharge mortality.
• KPS improved the prediction of post-discharge mortality when added to a baseline risk model.
• Enhanced predictive discrimination and calibration were observed with KPS inclusion.

Conclusions:

• Karnofsky Performance Status assessed at hospital discharge is a valuable tool for predicting post-discharge mortality in sepsis survivors in sub-Saharan Africa.
• Incorporating KPS into discharge planning can facilitate targeted interventions to enhance sepsis survivorship.
• This approach holds promise for improving outcomes in low- and middle-income countries.