Emergency Severity Index as a predictor of in-hospital mortality in suspected sepsis patients in the emergency department |
| |
| Institution: | 1. Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America;2. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, United States of America;3. Department of Emergency Medicine, University of Nebraska Medical Center (Bellevue Campus), Bellevue, NE, United States of America;4. Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States of America;1. US Acute Care Solutions, Canton, OH, United States of America;2. Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA, United States of America;3. Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States of America;4. Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, United States of America;5. Department of Emergency Medicine, Oklahoma State University, Tulsa, OK, United States of America;6. Department of Emergency, University of Nevada, Las Vegas School of Medicine, Las Vegas, NV, United States of America;7. Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, United States of America;8. Emergency Medical Services for Children Innovation and Improvement Center, Baylor College of Medicine, Houston, TX, United States of America;1. Emergency Department of Çank?r? State Hospital, Çank?r?, Turkey;2. Medical Faculty of Suleyman Demirel University, Emergency Medicine Department, Isparta, Turkey;3. Medical Faculty of Suleyman Demirel University, Department of Biochemistry, Turkey;4. Medical Faculty of Suleyman Demirel University, Department of Bioistatistics and Medical Informatics, Turkey;5. Emergency Department of Isparta State Hospital, Isparta, Turkey;1. Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran;2. Clinical Research Center, Afzalipoor Hospital, Kerman, Iran;3. Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran |
| |
| Abstract: | ObjectivesTo demonstrate the accuracy, sensitivity, and specificity of the Emergency Severity Index (ESI), quick Sepsis-related Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS) criteria, and National Early Warning Score (NEWS) for predicting in-hospital mortality and intensive care unit (ICU) admission in suspected sepsis patients.MethodsA retrospective cohort study conducted at a tertiary care hospital, Thailand. Suspected sepsis was defined by a combination of (1) hemoculture collection and (2) the initiation of intravenous antibiotics therapy during the emergency department (ED) visit. The accuracy of each scoring system for predicting in-hospital mortality and ICU admission was analyzed.ResultsA total of 8177 patients (median age: 62 years, 52.3% men) were enrolled in the study, 509 (6.2%) of whom died and 1810 (22.1%) of whom were admitted to the ICU. The ESI and NEWS had comparable accuracy for predicting in-hospital mortality (AUC of 0.70, 95% confidence interval CI] 0.68 to 0.73 and AUC of 0.73, 95% CI 0.70 to 0.75) and ICU admission (AUC of 0.75, 95% CI 0.74 to 0.76 and AUC of 0.74, 95% CI 0.72 to 0.75). The ESI level 1–2 had the highest sensitivity for predicting in-hospital mortality (96.7%), and qSOFA ≥2 had the highest specificity (86.6%).ConclusionThe ESI was accurate and had the highest sensitivity for predicting in-hospital mortality and ICU admission in suspected sepsis patients in the ED. This confirms that the ESI is useful in both ED triage and predicting adverse outcomes in these patients. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
