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J Emerg Med. 2009 Oct;37(3):319-27. doi: 10.1016/j.jemermed.2009.03.016. Epub 2009 May 8.

Risk stratification of the potentially septic patient in the emergency department: the Mortality in the Emergency Department Sepsis (MEDS) score.

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  • 1Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.

Abstract

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.

PMID:
19427752
[PubMed - indexed for MEDLINE]
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