The Mortality in Emergency Department Sepsis Score as a Predictor of 1-Month Mortality among Adult Patients with Sepsis: Weighing the Evidence

Bayushi Eka Putra,Ling Tiah

doi:10.1155/2013/896802

Abstract

Objective. To evaluate the performance of Mortality in Emergency Department Sepsis (MEDS) score in comparison to biomarkers as a predictor of mortality in adult emergency department (ED) patients with sepsis. Methods. A literature search was performed using PubMed, ScienceDirect, SpringerLink, and Ovid databases. Studies were appraised by using the C2010 Consensus Process for Levels of Evidence for prognostic studies. The respective values for area under the curve (AUC) were obtained from the selected articles. Results. Four relevant articles met the selection process. Three studies defined the 1-month mortality as death occurring within 28 days of ED presentation, while the remaining one subcategorised the outcome measure as (5-day) early and (6- to 30-day) late mortality. In all four studies, the MEDS score performed better than the respective comparators (C-reactive protein, lactate, procalcitonin, and interleukin-6) in predicting mortality with an AUC ranging from 0.78 to 0.89 across the studies. Conclusion. The MEDS score has a better prognostic value than the respective comparators in predicting 1-month mortality in adult ED patients with suspected sepsis.

Highlights

Sepsis and its spectrum of clinical entities remain one of the common critical illnesses encountered in the emergency department (ED) with an estimated mortality rate of 20– 30% in population-based studies [1, 2]
We aimed to evaluate the performance of the Mortality in Emergency Department Sepsis (MEDS) score in comparison to these biochemical markers as a predictor of mortality in adult ED patients with sepsis
Based on the previous results, the MEDS score remains a useful prognostic tool with better discriminative ability compared to the isolated use of C-reactive protein (CRP), PCT, and serum lactate for predicting 1-month mortality in adult ED patients with suspected sepsis across its clinical spectrum

Summary

Introduction

Sepsis and its spectrum of clinical entities remain one of the common critical illnesses encountered in the emergency department (ED) with an estimated mortality rate of 20– 30% in population-based studies [1, 2]. The severity of the condition may not be apparent at initial contact with ED personnel. This is made even more challenging in an evolving ED practice, where care is increasingly being delivered in overcrowded situations with limited resources, in urban settings with a heavy workload [6, 7]. In light of the above, the Mortality in Emergency Department Sepsis (MEDS) score was developed to address the ISRN Emergency Medicine.

Methods

Results

Conclusion