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Med Clin (Barc). 2019 Jun 4. pii: S0025-7753(19)30250-7. doi: 10.1016/j.medcli.2019.03.021. [Epub ahead of print]

Outcome prediction using the Mortality in Emergency Department Sepsis score combined with procalcitonin for influenza patients.

[Article in English, Spanish]

Author information

1
Emergency Department, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, South Road of Worker's Stadium, Chaoyang District, Beijing 100020, China.
2
Emergency Department, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, South Road of Worker's Stadium, Chaoyang District, Beijing 100020, China. Electronic address: shubinguo@126.com.

Abstract

BACKGROUND:

Severe influenza is often associated with bacterial coinfection and can trigger sepsis, which increases the severity, complexity and mortality of the disease. To determine an effective method for predicting 28-day mortality of emergency department (ED) patients with influenza, we investigated the Mortality in Emergency Department Sepsis (MEDS) score, procalcitonin (PCT) and other relevant biomarkers.

METHODS:

We conducted a retrospective, observational, monocentric study, and the endpoint was 28-day mortality. Independent predictors were identified and a new combination predictive model was created both by logistic regression, and the model was evaluated by a receiver operating characteristic (ROC) curve.

RESULTS:

A total of 364 consecutive ED admitted patients with influenza were enrolled and 45 patients died within 28 days. For predicting 28-day mortality, the MEDS score and PCT were independent predictors with adjusted odds ratio of 1.318 (95% CI 1.206-1.439) and 1.038 (95% CI 1.010-1.065), and with AUCs of 0.817 (95% CI 0.756-0.878) and 0.793 (95% CI 0.725-0.861), respectively. The new combination of the MEDS score with PCT significantly improved the efficacy for predicting 28-day mortality with an AUC of 0.857 (95% CI 0.809-0.905), and was superior to the SOFA score with an AUC of 0.837 (95% CI 0.779-0.894).

CONCLUSION:

The MEDS score and PCT, especially when combined, perform well for predicting mortality of ED admitted patients with influenza.

KEYWORDS:

Emergency department; Gripe; Influenza; MEDS score; Mortalidad; Mortality; Procalcitonin; Procalcitonina; Puntuación MEDS; Unidad de urgencias

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