%0 Journal Article
%T Prospective Comparison of Four Noninvasive Bedside Predictors of Mortality in Sepsis and Septic Shock
%A Burak Demir
%A Elif Arslan
%J Journal of Integrative Nursing and Palliative Care
%@ 3006-5550
%D 2026
%V 7
%N 1
%R 10.51847/1UsRSq4uoP
%P 116-125
%X Sepsis stands as a critical bodily dysfunction triggered by infection and remains a primary threat to public health worldwide. Detecting it early is frequently hampered by its vague initial presentation. While simple bedside metrics—including the shock index, diastolic shock index, capillary refill time (CRT), and mottling score (MS)—allow clinicians to monitor blood flow stability and estimate survival odds, their relative accuracy has not been directly compared. This paper analyzes how effectively these four instruments forecast patient mortality at three distinct intervals: 24 hours, 7 days, and 28 days. A prospective, single-center tracking study was executed between January and September 2024. The trial enrolled adult subjects (aged $\ge18$ years) who displayed signs of infection and a National Early Warning Score-2 of $\ge5$. Researchers recorded baseline characteristics, physiological signs, and initial CRT and MS values at admission, and subsequently monitored survival status at 24 hours, 7 days, and 28 days. The final analysis tracked 135 subjects (median age: 85 years; interquartile range: 79–90 years; 44.4% female). Fatality rates reached 15.6% within the first day, 25.2% by the first week, and 35.6% at four weeks. For immediate 24-hour survival tracking, CRT yielded the strongest predictive accuracy (area under the curve [AUC], 0.829; 95% confidence interval [CI], 0.755–0.889). Meanwhile, MS proved most accurate for intermediate outcomes at 7 days (AUC = 0.732; 95% CI = 0.646–0.806) and 28 days (AUC = 0.749; 95% CI = 0.662–0.823). Direct statistical comparisons between pairs showed no major differences in performance. Even though no single metric proved significantly superior to the rest, all four noninvasive examinations offer valuable insight for estimating survival probabilities during sepsis. CRT appears best suited for rapid, immediate risk tiering, whereas MS tracks more closely with mid-term clinical trajectories, supporting the routine use of both metrics during initial medical workups.
%U https://journalinpc.com/article/prospective-comparison-of-four-noninvasive-bedside-predictors-of-mortality-in-sepsis-and-septic-shoc-fuixdhfy0oke44u