UDFSSF Model is Superior to SOFA Score in Predicting 30-day Mortality of Septic Patients With Acute Kidney Injury

ObjectiveWhile the sequential organ failure assessment (SOFA) score is primarily utilized for sepsis severity stratification, its predictive performance for sepsis-associated acute kidney injury (SA-AKI) prognosis remains suboptimal. This study specifically focused on identifying 30-day mortality risk factors in SA-AKI patients and developing a novel prognostic model to enhance short-term outcome prediction in this critically ill population.Methods389 SA-AKI patients were finally enrolled and categorized into survivors (n = 286) and non-survivors (n = 103) based on 30-day survival status. The least absolute shrinkage and selection operator (LASSO), and univariate and multivariate logistic regression analyses were utilized to examine the independent risk factors associated with 30-day mortality. Calibration and decision curve analysis (DCA) curves were employed to assess the model's goodness of fit.ResultsSequential organ failure assessment score, urinary albumin-to-creatinine ratio (uAlb/Cr), D-dimer (D-D), fibrinogen (FIB), systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), and ferritin were independent risk factors for predicting 30-day mortality in SA-AKI patients. The uAlb/Cr + D-D + FIB + SIRI+SII + ferritin (UDFSSF) model showed an AUC of 0.975 (95% CI: 0.959-0.992), significantly outperforming the SOFA score (AUC: 0.716, 95% CI: 0.655-0.778).ConclusionDue to its multidimensional yet readily obtainable parameters, the UDFSSF model holds significant promise for clinical implementation as a superior forecasting tool for 30-day mortality of SA-AKI patients.