The Accuracy of Sepsis Screening Score for Mortality Prediction at Emergency Department Triage
Issued Date
2022-09-01
Resource Type
ISSN
1936900X
eISSN
19369018
Scopus ID
2-s2.0-85139571783
Pubmed ID
36205674
Journal Title
Western Journal of Emergency Medicine
Volume
23
Issue
5
Start Page
698
End Page
705
Rights Holder(s)
SCOPUS
Bibliographic Citation
Western Journal of Emergency Medicine Vol.23 No.5 (2022) , 698-705
Suggested Citation
Suttapanit K., Satiracharoenkul S., Sanguanwit P., Prachanukool T. The Accuracy of Sepsis Screening Score for Mortality Prediction at Emergency Department Triage. Western Journal of Emergency Medicine Vol.23 No.5 (2022) , 698-705. 705. doi:10.5811/westjem.2022.6.56754 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85541
Title
The Accuracy of Sepsis Screening Score for Mortality Prediction at Emergency Department Triage
Author's Affiliation
Other Contributor(s)
Abstract
Introduction: Sepsis has a mortality rate of 10-40% worldwide. Many screening tools for sepsis prediction and for emergency department (ED) triage are controversial. This study compared the accuracy of the scores for predicting 28-day mortality in adult patients with sepsis in the triage area of the ED. Methods: Adult patients who presented to the ED of a tertiary-care university hospital from January–December 2019 with an initial diagnosis of sepsis or other infection-related conditions were enrolled. We calculated predictive scores using information collected in the ED triage area. Prognostic accuracy was measured by the area under the receiver operating characteristic curve (AUROC) for predicting 28-day mortality as a primary outcome. The secondary outcomes included mechanical ventilation usage and vasopressor usage for 28 days. Results: We analyzed a total of 550 patients. The 28-day mortality rate was 12.4% (n = 68). The 28-day mortality rate was best detected by the National Early Warning Score (NEWS) (AUROC = 0.770; 95% confidence interval [CI]: 0.705-0.835), followed by the quick Sequential Organ Failure Assessment (qSOFA) score (AUROC = 0.7473; 95% CI: 0.688-0.806), Search Out Severity (SOS) score (AUROC = 0.749; 95% CI: 0.685-0.815), Emergency Severity Index (ESI) triage (AUROC = 0.599; 95% CI: 0.542-0.656, and the Systemic Inflammatory Response System (SIRS) criteria (AUROC = 0.588; 95% CI: 0.522-0.654]). The NEWS also provided a higher AUROC and outperformed for 28-day mechanical ventilator usage and 28-day vasopressor usage. Conclusion: The NEWS outperforms qSOFA, SOS, SIRS, and ESI triage in predicting 28-day mortality, mechanical ventilator, and vasopressor usage of a patient with sepsis who is seen at ED triage.