What question did this study set out to answer?

The review aims to systematically evaluate the quality and applicability of risk prediction models for sepsis-associated encephalopathy.

February 16, 2026Open Access

Risk prediction models for sepsis-associated encephalopathy: a systematic evaluation and meta-analysis

THTing HeUniversity of Groningen TJTuo quan JiaoChengdu University of Traditional Chinese Medicine XAXue mei AnShanghai University of Traditional Chinese Medicine

Key Points

The review aims to systematically evaluate the quality and applicability of risk prediction models for sepsis-associated encephalopathy.
Conducted a systematic search of various databases to identify studies on SAE risk prediction models.
Two independent reviewers screened studies and extracted relevant data.
Evaluated risk of bias and applicability using the PROBAST tool.
Identified 1,994 studies, with 10 meeting inclusion criteria.
Incidence of SAE reported between 15.16% and 63.3%.
Both age and SOFA score showed significant predictive value.
Pooled area under the curve (AUC) for validated models was 0.83, indicating fair discrimination.

Abstract

Background The number of risk prediction models for sepsis-associated encephalopathy (SAE) is increasing, while the quality and applicability of these models in clinical practice and future research remain uncertain. Objective To systematically review published studies on SAE risk prediction models. Design Systematic review and meta-analysis of observational studies. Methods A systematic search of PubMed, Web of Science, Embase, Wanfang, VIP, and CNKI databases was conducted from inception to April 2, 2025, to identify studies on SAE risk prediction models. Two independent reviewers screened the studies and extracted data. The Prediction model Risk Of Bias Assessment Tool (PROBAST) was applied to evaluate the risk of bias and applicability of the included studies. Results A total of 1,994 studies were identified, and 10 were included after screening. The reported incidence of SAE ranged from 15.16% to 63.3%. Age and Sequential Organ Failure Assessment (SOFA) score are the most frequently adopted factors with significant predictive value, both of which were incorporated into five models. Both the SOFA score and age were significantly associated with SAE. In studies with available data, the odds ratio (OR) for age ranged from 1.084 to 1.018, while that for SOFA score ranged from 1.246 to 2.416. The area under the receiver operating characteristic curve (AUC) for the 10 studies ranged from 0.743 to 0.975. All studies were found to have a high risk of bias, primarily due to inappropriate data sources and deficiencies in the analysis domain. The pooled AUC for the six validated models was 0.83 (95% confidence interval 0.77–0.89), indicating fair discrimination. Conclusion Although the included studies reported some discrimination in the SAE prediction models, all were found to have a high risk of bias according to the PROBAST checklist. Registration This study protocol was registered on PROSPERO (registration number: CRD420251012485).

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