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Journal of The Korean Society of Emergency Medicine 2016;27(4): 301-312. |
| 응급실을 통해 중환자실에 입원한 패혈증 환자의 예후 예측 |
| 장상민, 김종원, 김신영, 이경룡, 박상오, 백광제, 홍대영 |
| 건국대학교 의학전문대학원 응급의학교실 |
| Comparing the Usefulness of the Initial Predisposition Infection Response Organ Failure Score and the Mortality in Emergency Department Sepsis Score for Predicting the Prognosis of Septic Patients Admitted to the Intensive Care Unit |
| Sang Min Jang, Jong Won Kim, Sin Young Kim, Kyeong Ryong Lee, Sang O Park, Kwang Je Baek, Dae Young Hong |
| Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University College of Medicine, Seoul, Korea |
| Correspondence |
Dae Young Hong ,Tel: 02-2030-5551, Fax: 02-2030-5789, Email: 20070123@kuh.ac.kr,
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Received: May 2, 2016; Revised: May 3, 2016 Accepted: July 4, 2016. Published online: August 31, 2016. |
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| ABSTRACT |
Purpose:
The predisposition infection response organ failure (PIRO) score has been developed to be used in the emergency department (ED) to risk stratify sepsis case but has not been well studied domestically. The aim of this study was to compare the usefulness between the PIRO score and the mortality in emergency department sepsis (MEDS) score in predicting the mortality of septic patients admitted to the intensive care unit (ICU).
Method:
We conducted a retrospective study of patients who were suspected to have sepsis and were admitted to the ICU via the ED during a period between January 2013 and June 2015. PIRO and MEDS scores were calculated from the ED data. A comparative analysis was performed the evaluate the areas under the receiver operator characteristic (ROC) curves for 28-day mortality.
Results:
During the 30-month period, a total of 199 patients diagnosed with sepsis were enrolled. Fifty-seven patients (28.6%) died within 28 days of presentation. The PIRO score showed increasing mortality with higher scores. The area under the ROC curve (AUC) for mortality was 0.890 (95% confidence interval [CI]=0.830 to 0.950) for PIRO and 0.705 (95% CI=0.609 to 0.801) for MEDS score.
Conclusion:
The MEDS score in the ED did not predict mortality better than PIRO score. The PIRO score was a good predictor of the outcome for patients with suspected sepsis. We believe that the PIRO score may be the most useful and appropriate clinical prediction tool for patients with suspected sepsis in the ED. |
| Key words:
Emergency service, Hospital, Hospital mortality, Intensive care unit, Prognosis, Sepsis |
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