The Prediction of Mortality by the REDS score in Sepsis Patients at Emergency Department
Abstract
Background: Sepsis is a life-threatening condition which should be early recognized for accurate diagnosis and appropriate management. REDS score is a scoring system that provides the screening and predicts 28-day in-hospital mortality in septic patients who were treated at emergency department.
Objective: This study aims to predict 28-day in-hospital mortality by the REDS score in patients with sepsis.
Methods: A single-center, retrospective cross-sectional study was conducted in emergency department of Chonburi hospital between 1st October 2019 to 31st January 2020. Patients demographic data were recorded from the beginning of treatment to the time of admission. REDS score was analyzed by using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic curve (AUROC) for predicting 28-day in-hospital mortality and compared with the sMISSED and qSOFA scores.
Result: 263 patients were enrolled to the study. REDS score was a better predictor for 28-day in-hospital mortality when compared with the sMISSED and qSOFA scores. The best cut-off point of REDS score was 5 points with sensitivity, specificity, PPV and NPV were 80%, 54.3%, 23,9% and 93.8%, respectively. AUROC of sMISSED, qSOFA and REDS scores in prediction of 28-day in-hospital mortality were 0.683, 0.587 and 0.743 respectively.
Conclusion: The REDS score is a best scoring system to prediction of mortality rate in ED patients with sepsis when compared to its component scores.
References
Sivayoham N, Blake LA, Tharimoopantavida SE, Chughtai S, Hussain AN, Cecconi M, et al. The REDS score: a new scoring system to risk-stratify emergency department suspected sepsis: a derivation and validation study. BMJ Open 2019;9:1-10.
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 2016;315:801-10.
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock:2016. Crit Care Med 2017;45:486-552.
Angus DC, Poll TV. Severe sepsis and septic shock. N Engl J Med.2013;369:840-51.
Cohen J, Vincent JL, Adhikari NKJ, Machado FR, Angus DC, Calandra T, et al. Sepsis: a roadmap for future research. Lancet Infect Dis 2015;15:581-614.
Peake SL, Delaney A, Bailey M, Bellomo R, Cameron PA, Cooper J, et al. Goal-directed resuscitation for patients with early septic shock. N Engl J Med 2014;371:1496-506.
Yealy DM, Kellum JA, Huang DT, Barnato AE, Weissfeld LA, Pike F, et al. A Randomized Trial of Protocol-Based Care for Early Septic Shock. N Engl J Med 2014;370 :1683-93.
Mouncey PR, Osborn TM, Power GS, Harrison DA, Sadique MZ, Grieve RD, et al. Trial of Early, Goal-Directed Resuscitation for Septic Shock. N Engl J Med 2015;372:1301-11.
Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the third International consensus deinitions for sepsis and septic shock (Sepsis-3). JAMA 2016;315:762–74.
Freund Y, Lemachatti N, Krastinova E, Laer MV, Claessens YE, Avondo A, et al. Prognostic accuracy of Sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA 2017;317:301–8.
Churpek MM, Snyder A, Han X, Sokol S, Pettit N, Howell MD, et al. Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit. Am J Respir Crit Care Med 2017;195:906–11.
Song JU, Sin CK, Park HK, Shim SR, Lee J. Performance of the quick sequential (sepsis-related) organ failure assessment score as a prognostic tool in infected patients outside the intensive care unit: a systematic review and meta-analysis. Crit Care Med 2018;22:28.
Fernando SM, Tran A, Taljaard M, Cheng W, Rochwerg B, Seely AJE, et al. Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection: a systematic review and meta-analysis. Ann Intern Med 2018;168:266–75.
Sivayoham N, Holmes P, Cecconi M, Rhodes A. The Simplified Mortality In Severe Sepsis in the emergency department (MISSED) score to risk stratify ED sepsis. Emergency Medicine Journal 2015;32:986-987.
Sivayoham N, Holmes P, Cecconi M, Rhodes A. Internal emergency department validation of the simplified missed score. Eur J Emerg Med 2015;22:321–6.
Sabir L, Ramlakhan S, Goodacre S. Comparison of qSOFA and Hospital Early Warning Scores for prognosis in suspected sepsis in emergency department patients: a systematic review. Emerg Med J 2022;39:284-294.
Khwannimit B, Bhurayanontachai R, Vattanavanit V. Comparison of the accuracy of three early warning scores with SOFA score for predicting mortality in adult sepsis and septic shock patients admitted to intensive care unit. Heart Lung 2019;48:240-244.
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