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Scores for sepsis detection and risk stratification - construction of a novel score using a statistical approach and validation of RETTS
- Source :
- PLoS ONE, PLoS ONE, Vol 15, Iss 2, p e0229210 (2020)
- Publication Year :
- 2019
-
Abstract
- BACKGROUND:To allow early identification of patients at risk of sepsis in the emergency department (ED), a variety of risk stratification scores and/or triage systems are used. The first aim of this study was to develop a risk stratification score for sepsis based upon vital signs and biomarkers using a statistical approach. Second, we aimed to validate the Rapid Emergency Triage and Treatment System (RETTS) for sepsis. RETTS combines vital signs with symptoms for risk stratification. METHODS:We retrospectively analysed data from two prospective, observational, multicentre cohorts of patients from studies of biomarkers in ED. A candidate risk stratification score called Sepsis Heparin-binding protein-based Early Warning Score (SHEWS) was constructed using the Least Absolute Shrinkage and Selector Operator (LASSO) method. SHEWS and RETTS were compared to National Early Warning Score 2 (NEWS2) for infection-related organ dysfunction, intensive care or death within the first 72h after admission (i.e. sepsis). RESULTS:506 patients with a diagnosed infection constituted cohort A, in which SHEWS was derived and RETTS was validated. 435 patients constituted cohort B of whom 184 had a diagnosed infection where both scores were validated. In both cohorts (A and B), AUC for infection-related organ dysfunction, intensive care or death was higher for NEWS2, 0.80 (95% CI 0.76-0.84) and 0.69 (95% CI 0.63-0.74), than RETTS, 0.74 (95% CI 0.70-0.79) and 0.55 (95% CI 0.49-0.60), p = 0.05 and p
- Subjects :
- Adult
Male
Critical Care and Emergency Medicine
Pulmonology
Science
Cardiology
Blood Pressure
Pathology and Laboratory Medicine
Risk Assessment
Biochemistry
Vascular Medicine
Signs and Symptoms
Predictive Value of Tests
Diagnostic Medicine
Heart Rate
Sepsis
Medicine and Health Sciences
Humans
Hospital Mortality
Prospective Studies
Emergency Treatment
Aged
Retrospective Studies
Aged, 80 and over
Models, Statistical
Biology and Life Sciences
Middle Aged
Hospitalization
Oxygen
Chemistry
ROC Curve
Respiratory Infections
Physical Sciences
Medicine
Female
Triage
Emergency Service, Hospital
Biomarkers
Follow-Up Studies
Research Article
Chemical Elements
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 15
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- PloS one
- Accession number :
- edsair.pmid.dedup....d3dff7082613fddd82c24383e56c1d49