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Crit Care Med. 2007 Jan;35(1):192-8.

Mortality in Emergency Department Sepsis (MEDS) score predicts 1-year mortality.

Author information

  • 1Department of Emergency Medicine, Pulmonary and Critical Care Division, Beth Israel Deaconess Medical Center, Boston, MA.

Abstract

OBJECTIVE:

To assess the predictive performance for 1-yr mortality of the previously derived and validated Mortality in Emergency Department Sepsis (MEDS) score.

DESIGN:

Prospective cohort study.

PATIENTS:

Consecutive adult (aged > or =18 yrs) emergency department patients presenting to an urban, tertiary care, university hospital were eligible if they had a clinically suspected infection as indicated by the decision to obtain a blood culture. The enrollment period was between February 1, 2000, and February 1, 2001. Of 3,926 eligible patient visits, 3,762 (96%) were enrolled and 3,102 unique first visits were analyzed.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A total of 667 patients (21.5%) died within 1 yr. The unadjusted 1-yr mortality rates for the MEDS risk groups were: very low risk, 7%; low risk, 20%; moderate risk, 37%; high risk, 64%; very high risk, 80%. Using a Cox proportional hazard model that controlled for age, sex, and Charlson co-morbidity index, the 1-yr hazard ratios compared with the baseline very low-risk group were: low risk, 2.2 (1.7-2.9); moderate risk, 3.5 (2.7-4.6); high risk, 6.7 (4.9-9.3); and very high risk, 10.5 (7.2-15.4). The groups were significantly different (p < .0001).

CONCLUSIONS:

Although the score was initially derived for 28-day in-hospital mortality, our results indicate that the MEDS score also predicts patient survival at 1 yr after index hospital visit with suspected infection. The score needs external validation before widespread use.

Comment in

PMID:
17110874
[PubMed - indexed for MEDLINE]
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