Internal XXXX validation of the simplified MISSED score.

@entity1 @entity295 @entity341 @entity204 @entity1229
BACKGROUND: The MISSED score was derived and validated in @entity341 ( @entity341 ) @entity1 with @entity295 who were admitted to the ICU. This score has now been refined and simplified. The independent variables associated with mortality are age at least 65 years, serum albumin 27   g/l or less, and an international normalized ratio at least 1.3. The simplified MISSED score ranges from 0 to 3 depending on the number of variables present. OBJECTIVE: The primary objective is to validate the simplified MISSED score for predicting all-cause mortality in the @entity341 population admitted with @entity295 . The secondary end-point is to validate the risk stratification for ICU admission. METHODS: This is a pragmatic retrospective study of prospectively collected data. @entity341 @entity1 admitted with a diagnosis of @entity295 in the year 2012 were studied. Those on @entity1229 were excluded. The simplified MISSED score was calculated for each @entity1 . The test characteristics for mortality of the simplified MISSED score and the odds ratios of the high-risk groups for the secondary end-point were calculated. RESULTS: In total, 674 @entity1 , including 65 @entity204 , were studied. The area under the curve for the simplified MISSED score was 0.74 [95% confidence interval (CI) 0.70-0.77; P<0.0001]. The test characteristics for mortality were as follows: sensitivity 93.9% (95% CI 85-98.3), specificity 37.9% (95% CI 34.1-41.9), positive predictive value 13.9% (95% CI 10.8-17.5), and negative predictive value 98.3% (95% CI 95.7-99.5). The odds ratio for mortality for a score 2 or more was 5.01 (95% CI 2.93-8.57; P<0.0001), and that for ICU admission was 3.00 (95% CI 1.70-5.28; P=0.0001). CONCLUSION: The simplified MISSED score could be used to risk stratify septic @entity1 in the @entity341 .
