ArticleBMC emergency medicine2021
Prognostic scores and early management of septic patients in the emergency department of a secondary hospital: results of a retrospective study.
Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review.Annals of internal medicine · 2025Pooled it
- Probiotic Supplementation Prevents the Development of Ventilator-Associated Pneumonia for Mechanically Ventilated ICU Patients: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.Frontiers in nutrition · 2022Pooled it
- Article
- Predictive Value of SAPS II for 28-Day All-Cause Mortality in AECOPD Patients Admitted to the ICU.International journal of chronic obstructive pulmonary disease · 2026Article
- The predictive performance of NEWS, MEWS, SOFA and SAPS II in outcomes of bacteremic and non-bacteremic sepsis.BMC infectious diseases · 2025Observational
- Development and Validation of a NEWS2-Enhanced Multivariable Prediction Model for Clinical Deterioration and In-Hospital Mortality in Hospitalized Adults.Medicina (Kaunas, Lithuania) · 2025Article
- Diagnostic values of noradrenaline administered dose, procalcitonin (PCT) and blood lactic acid for septic shock.Journal of medical biochemistry · 2025Article
- Which model is superior in predicting ICU survival: artificial intelligence versus conventional approaches.BMC medical informatics and decision making · 2022Article
- Development and Validation of the Acute PNeumonia Early Assessment Score for Safely Discharging Low-Risk SARS-CoV-2-Infected Patients from the Emergency Department.Journal of clinical medicine · 2022Article
- A Least Absolute Shrinkage and Selection Operator (LASSO)-derived AAGC Model for In-hospital Mortality Prediction in Sepsis Incorporating Age, APACHE II Score, Glasgow Coma Scale, and Creatinine: A Prospective Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care MedicineArticle
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSequential Organ Failure Assessment (SOFA) and other illness prognostic scores predict adverse outcomes in critical patients. Their validation as a decision-making tool in the emergency department (ED) of secondary hospitals is not well established. The aim of this study was to compare SOFA, NEWS2, APACHE II, and SAPS II scores as predictors of adverse outcomes and decision-making tool in ED.
methodsData of 121 patients (age 73 ± 10 years, 58% males, Charlson Comorbidity Index 5.7 ± 2.1) with a confirmed sepsis were included in a retrospective study between January 2017 and February 2020. Scores were computed within the first 24 h after admission. Primary outcome was the occurrence of either in-hospital death or mechanical ventilation within 7 days. Secondary outcome was 30-day all-cause mortality.
resultsPatients older than 64 years (elderly) represent 82% of sample. Primary and secondary outcomes occurred in 40 and 44%, respectively. Median 30-day survival time of dead patients was 4 days (interquartile range 1-11). The best predictive score based on the area under the receiver operating curve (AUROC) was SAPS II (0.823, 95% confidence interval, CI, 0.744-0.902), followed by APACHE II (0.762, 95% CI 0.673-0.850), NEWS2 (0.708, 95% CI 0.616-0.800), and SOFA (0.650, 95% CI 0.548-0.751). SAPS II cut-off of 49 showed the lowest false-positive rate (12, 95% CI 5-20) and the highest positive predictive value (80, 95% CI 68-92), whereas NEWS2 cut-off of 7 showed the lowest false-negative rate (10, 95% CI 2-19) and the highest negative predictive value (86, 95% CI 74-97). By combining NEWS2 and SAPS II cut-offs, we accurately classified 64% of patients. In survival analysis, SAPS II cut-off showed the highest difference in 30-day mortality (Hazards Ratio, HR, 5.24, 95% CI 2.99-9.21, P < 0.001). Best independent negative predictors of 30-day mortality were body temperature, mean arterial pressure, arterial oxygen saturation, and hematocrit levels. Positive predictors were male sex, heart rate and serum sodium concentration.
conclusionsSAPS II is a good prognostic tool for discriminating high-risk patient suitable for sub-intensive/intensive care units, whereas NEWS2 for discriminating low-risk patients for low-intensive units. Our results should be limited to cohorts with a high prevalence of elderly or comorbidities.
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