Evaluation of the modified MEDS, MEWS score and Charlson comorbidity index in patients with community acquired sepsis in the emergency department
- 19 December 2012
- journal article
- Published by Springer Science and Business Media LLC in Internal and Emergency Medicine
- Vol. 8 (3), 255-260
- https://doi.org/10.1007/s11739-012-0890-x
Abstract
Sepsis is one of the most important causes of morbidity and mortality in patients presenting to the emergency department. SIRS criteria that define sepsis are not specific and do not reflect the severity of infection. We aimed to evaluate the ability of the modified mortality in emergency department sepsis (MEDS) score, the modified early warning score (MEWS) and the Charlson comorbidity index (CCI) to predict prognosis in patients who are diagnosed in sepsis. We prospectively investigated the value of the CCI, MEWS and modified MEDS Score in the prediction of 28-day mortality in patients presenting to the emergency department who were diagnosed with sepsis. 230 patients were enrolled in the study. In these patients, the 5-day mortality was 17 % (n = 40) and the 28-day mortality was 32.2 % (n = 74). A significant difference was found between surviving patients and those who died in terms of their modified MEDS, MEWS and Charlson scores for both 5-day mortality (p < 0.001, p = 0.013 and p = 0.006, respectively) and 28-day mortality (p < 0.001, p = 0.008 and p < 0.001, respectively). The area under the curve (AUC) for the modified MEDS score in terms of 28-day mortality was 0.77. The MEDS score had a greater prognostic value compared to the MEWS and CCI scores. The performance of modified MEDS score was better than that of other scoring systems, in our study. Therefore, we believe that the modified MEDS score can be reliably used for the prediction of mortality in sepsis.Keywords
This publication has 21 references indexed in Scilit:
- The value of the Mortality in Emergency Department Sepsis (MEDS) score, C reactive protein and lactate in predicting 28-day mortality of sepsis in a Dutch emergency departmentEmergency Medicine Journal, 2011
- Assessment of disease-severity scoring systems for patients with sepsis in general internal medicine departmentsCritical Care, 2011
- Comparison of severity of illness scoring systems in the prediction of hospital mortality in severe sepsis and septic shockJournal of Emergencies, Trauma, and Shock, 2010
- Prediction of mortality in adult emergency department patients with sepsisEmergency Medicine Journal, 2009
- Performance of the Mortality in emergency department Sepsis score for predicting hospital mortality among patients with severe sepsis and septic shockThe American Journal of Emergency Medicine, 2008
- MORTALITY PREDICTIONS USING CURRENT PHYSIOLOGIC SCORING SYSTEMS IN PATIENTS MEETING CRITERIA FOR EARLY GOAL-DIRECTED THERAPY AND THE SEVERE SEPSIS RESUSCITATION BUNDLEShock, 2008
- PROGNOSTIC VALUE OF MORTALITY IN EMERGENCY DEPARTMENT SEPSIS SCORE, PROCALCITONIN, AND C-REACTIVE PROTEIN IN PATIENTS WITH SEPSIS AT THE EMERGENCY DEPARTMENTShock, 2008
- Performance of Severity of Illness Scoring Systems in Emergency Department Patients with InfectionAcademic Emergency Medicine, 2007
- Performance of Severity of Illness Scoring Systems in Emergency Department Patients with InfectionAcademic Emergency Medicine, 2007
- American College of Chest Physicians/Society of Critical Care Medicine Consensus ConferenceCritical Care Medicine, 1992