Automated CT visceral-to-subcutaneous fat ratio predicts sepsis mortality in multicenter study

In 1716 sepsis patients, automated CT-derived visceral-to-subcutaneous fat ratio independently predicted mortality (HR 2.117, 95% CI 1.946-2.301) and improved model C-index by up to 0.080 over clinical variables.

• Extra survival trees model achieved internal validation C-index 0.845 and mean time-dependent AUC 0.905.
• VSR interacted with lactic acid (p=0.008) and procalcitonin (p=0.026).
• Adding VSR increased clinical model C-index by 0.049, 0.080, and 0.020 in training, internal validation, and external validation cohorts.

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