This is because many patients who recover from severe sepsis die later from pre-existing chronic illnesses. Moreover, outcomes and risk factors of patients with severe sepsis vary considerably with the number of episodes and with U0126 clinical the time and place (community, hospital or ICU) of acquisition.The objective of this study was to design a prognostic model for predicting death within 14 days of severe sepsis onset at any time during the first 28 days of the ICU stay. The model was to be based on variables collected at admission and on the day the sepsis episode was diagnosed. Up to four sepsis episodes per patient were included. We evaluated the performance of our model separately in subgroups defined based on the place of infection acquisition. We compared our model with other, widely used scores.

Our model may prove useful for designing future studies.Methods and materialsData sourceWe conducted a prospective observational study using data entered into a multicentre database (OUTCOMEREA?) from November 1996 to April 2007. The database, with input from 12 French ICUs, contains data on admission features and diagnosis, daily disease severity, iatrogenic events, nosocomial infections and vital status. Data for a random sample of at least 50 patients older than 16 years and having ICU stays longer than 24 hours were consecutively entered into the database each year. Each participating ICU chose to perform random sampling by taking either consecutive admissions to selected ICU beds throughout the year or consecutive admissions to all ICU beds over a single month.

The contact physicians for the database in the participating ICUs, who are listed in the appendix, are accredited according to French law [5].Ethical issuesAccording to French law, this study did not require patient consent, because it involved research on a database. The study was approved by the institutional review board of the Centres d’Investigation Rh?ne-Alpes-Auvergne.Data Entinostat collectionData were collected daily by senior physicians in the participating ICUs. For each patient, the data were entered into an electronic case-report form using VIGIREA? and RHEA? data-capture software (OUTCOMEREA?, Rosny-sous-Bois, France), and all case-report forms were then entered into the OUTCOMEREA? data warehouse. All codes and definitions were established prior to study initiation. The following information was recorded for each patient: age, sex, admission category (medical, scheduled surgery or unscheduled surgery), origin (home, ward or emergency room) and McCabe score [6]. Based on previously reported reproducibility data, the McCabe score was transformed into a dummy variable, that is, ‘death expected within five years, yes or no’ [7].