BACKGROUND: The prompt recognition and management of septic patients remains a challenge within the busy Emergency Department (ED). Prognostic screening aids have traditionally required time-delayed laboratory measurements not validated upon the emergency medicine population. Recently, a brief prognostic tool has been derived and subsequently validated in heterogeneous ED populations. CLINICAL QUESTION: Can a risk-stratification tool predict 1-month mortality in ED patients with suspected infection? EVIDENCE REVIEW: Six studies evaluating the Mortality in the Emergency Department Sepsis (MEDS) score were identified and evaluated. RESULTS: Higher MEDS scores are associated with increasing mortality. MEDS score's short- and long-term prognostic accuracy is superior to other sepsis scales as well as isolated biomarkers C-reactive protein and procalcitonin. MEDS' prognostic accuracy in severe sepsis is inferior to undifferentiated systemic inflammatory response syndrome (SIRS) patients. CONCLUSION: The MEDS score is an accurate and reliable prognostic tool for 28-day mortality in ED SIRS patients, but may not be optimal for those with severe sepsis.
BACKGROUND: The prompt recognition and management of septicpatients remains a challenge within the busy Emergency Department (ED). Prognostic screening aids have traditionally required time-delayed laboratory measurements not validated upon the emergency medicine population. Recently, a brief prognostic tool has been derived and subsequently validated in heterogeneous ED populations. CLINICAL QUESTION: Can a risk-stratification tool predict 1-month mortality in ED patients with suspected infection? EVIDENCE REVIEW: Six studies evaluating the Mortality in the Emergency Department Sepsis (MEDS) score were identified and evaluated. RESULTS: Higher MEDS scores are associated with increasing mortality. MEDS score's short- and long-term prognostic accuracy is superior to other sepsis scales as well as isolated biomarkers C-reactive protein and procalcitonin. MEDS' prognostic accuracy in severe sepsis is inferior to undifferentiated systemic inflammatory response syndrome (SIRS) patients. CONCLUSION: The MEDS score is an accurate and reliable prognostic tool for 28-day mortality in ED SIRS patients, but may not be optimal for those with severe sepsis.
Authors: Christopher R Carpenter; Bryan G Kane; Merle Carter; Raymond Lucas; Lee G Wilbur; Charles S Graffeo Journal: Acad Emerg Med Date: 2010-10 Impact factor: 3.451
Authors: Andrew Worster; Kulamakan Kulasegaram; Christopher R Carpenter; Teresa Vallera; Suneel Upadhye; Jonathan Sherbino; R Brian Haynes Journal: Acad Emerg Med Date: 2011-11 Impact factor: 3.451
Authors: Kay M Tomashek; Christopher J Gregory; Aidsa Rivera Sánchez; Matthew A Bartek; Enid J Garcia Rivera; Elizabeth Hunsperger; Jorge L Muñoz-Jordán; Wellington Sun Journal: PLoS Negl Trop Dis Date: 2012-04-17
Authors: Julian M Williams; Jaimi H Greenslade; Juliet V McKenzie; Kevin H Chu; Anthony F T Brown; David Paterson; Jeffrey Lipman Journal: BMC Infect Dis Date: 2011-01-26 Impact factor: 3.090