A comparison of scoring systems for predicting mortality and sepsis in the emergency department patients with a suspected infection

Manita Thodphetch; Boriboon Chenthanakij; Borwon Wittayachamnankul; Kamphee Sruamsiri; Theerapon Tangsuwanaruk

doi:https://doi.org/10.15441/ceem.20.145

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자료유형: 학술저널

저자정보: Manita Thodphetch (Department of Emergency Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand) Boriboon Chenthanakij (Department of Emergency Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand) Borwon Wittayachamnankul (Department of Emergency Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand) Kamphee Sruamsiri (Department of Emergency Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand) Theerapon Tangsuwanaruk (Department of Emergency Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand)

저널정보: 대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.8 No.4

발행연도: 2021.12

수록면: 289 - 295 (7page)

DOI: https://doi.org/10.15441/ceem.20.145

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Objective We aimed to compare the modified National Early Warning Score (mNEWS), quick Sequential Organ Failure Assessment (qSOFA) score, modified Systemic Inflammatory Response Syndrome (mSIRS) score, and modified Search Out Severity (mSOS) score in predicting mortality and sepsis among patients suspected of first observed infections in the emergency department. The modified scores were created by removing variables for simplicity. Methods This was a prospective cohort study that enrolled adult patients presenting at the emergency department with signs and symptoms suggesting infection. The mNEWS, qSOFA score, mSIRS score, and mSOS score were calculated using triage data. The SOFA score was a reference standard for sepsis diagnosis. All patients were monitored for up to 30 days after the initial visit to measure each scoring system’s ability to predict 30-day mortality and sepsis. Results There were 260 patients included in the study. The 30-day mortality prediction with mNEWS ≥5 had the highest sensitivity (91.18%). The highest area under the receiver operating characteristic curve (AUC) for the 30-day mortality prediction was mNEWS (0.607), followed by qSOFA (0.605), mSOS (0.550), and mSIRS (0.423). The sepsis prediction with mNEWS ≥5 had the highest sensitivity (96.48%). The highest AUC for the sepsis prediction was also mNEWS (0.685), followed by qSOFA (0.605), mSOS (0.480), and mSIRS (0.477). Conclusion mNEWS was an acceptable scoring system screening tool for predicting mortality and sepsis in patients with a suspected infection.

#Emergency service #hospital #Mortality #Clincal decision rule #Prognosis #Sepsis

참고문헌 (19)

참고문헌 신청

Rudd KE / 2020 / Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study / Lancet 395:200~211

Levy MM / 2018 / The Surviving Sepsis Campaign Bundle : 2018 update / Crit Care Med 46:997~1000

Seymour CW / 2016 / Assessment of clinical criteria for sepsis : for the Third International Consensus definitions for sepsis and septic shock(Sepsis-3) / JAMA 315:762~774

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Herwanto V / 2019 / Accuracy of quick sequential organ failure assessment score to predict sepsis mortality in 121 studies including 1,716,017 individuals: a systematic review and meta-analysis / Crit Care Explor 1:e0043

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