@article {7931,
	title = {Validation of the REGARDS Severe Sepsis Risk Score.},
	journal = {J Clin Med},
	volume = {7},
	year = {2018},
	month = {2018 Dec 11},
	abstract = {<p>There are no validated systems for characterizing long-term risk of severe sepsis in community-dwelling adults. We tested the ability of the REasons for Geographic and Racial Differences in Stroke-Severe Sepsis Risk Score (REGARDS-SSRS) to predict 10-year severe sepsis risk in separate cohorts of community-dwelling adults. We internally tested the REGARDS-SSRS on the REGARDS-Medicare subcohort. We then externally validated the REGARDS-SSRS using (1) the Cardiovascular Health Study (CHS) and (2) the Atherosclerosis Risk in Communities (ARIC) cohorts. Participants included community-dwelling adults: REGARDS-Medicare, age >=65 years,  = 9522; CHS, age >=65 years,  = 5888; ARIC, age 45$^{-}$64 years,  = 11,584. The primary exposure was 10-year severe sepsis risk, predicted by the REGARDS-SSRS from participant sociodemographics, health behaviors, chronic medical conditions and select biomarkers. The primary outcome was first severe sepsis hospitalizations, defined as the concurrent presence of ICD-9 discharge diagnoses for a serious infection and organ dysfunction. Median SSRS in the cohorts were: REGARDS-Medicare 11 points (IQR 7$^{-}$16), CHS 10 (IQR 6$^{-}$15), ARIC 7 (IQR 5$^{-}$10). Severe sepsis incidence rates were: REGARDS-Medicare 30.7 per 1000 person-years (95\% CI: 29.2$^{-}$32.2); CHS 11.9 (10.9$^{-}$12.9); ARIC 6.8 (6.3$^{-}$7.3). SSRS discrimination for first severe sepsis events were: REGARDS-Medicare C-statistic 0.704 (95\% CI: 0.691$^{-}$0.718), CHS 0.696 (0.675$^{-}$0.716), ARIC 0.697 (0.677$^{-}$0.716). The REGARDS-SRSS may potentially play a role in identifying community-dwelling adults at high severe sepsis risk.</p>},
	issn = {2077-0383},
	doi = {10.3390/jcm7120536},
	author = {Wang, Henry E and Donnelly, John P and Yende, Sachin and Levitan, Emily B and Shapiro, Nathan I and Dai, Yuling and Zhao, Hong and Heiss, Gerardo and Odden, Michelle and Newman, Anne and Safford, Monika}
}
