The role of the HOTEL score in predicting prognosis in patients with sepsis and septic shock in the emergency department.

Sepsis and septic shock represent significant health concerns in emergency departments due to their high mortality rates. This study aimed to evaluate the prognostic predictive ability of the HOTEL score in patients diagnosed with sepsis and septic shock in the emergency department. This single-center, prospective, observational diagnostic evaluation study included a total of 151 patients who presented to the emergency department between August 1, 2023, and March 1, 2024, and were diagnosed with sepsis or septic shock. The demographic, clinical, and laboratory data of the patients were recorded. The HOTEL score was calculated based on parameters including systolic blood pressure, oxygen saturation, body temperature, electrocardiographic changes, and loss of independence. Statistical analyses included receiver operating characteristic curves, logistic regression, and diagnostic test performance metrics. The median age of the included patients was 75 (interquartile range: 66.5-83.5) years. In terms of 30-day mortality, the HOTEL score (area under the curve [AUC]: 0.607) and SOFA score (AUC: 0.612) demonstrated similar predictive ability. Regarding the need for intubation in the emergency department, the HOTEL score (AUC: 0.773) and SOFA score (AUC: 0.835) were statistically significant. Multivariate analysis identified the HOTEL score, C-reactive protein levels, and the presence of active malignancy as independent predictors of 30-day mortality. Among the parameters of the HOTEL score, loss of independence emerged as the most significant predictor. According to the results of our study, the HOTEL score serves as an independent predictor of short-term mortality in patients with sepsis and septic shock. It may be a useful tool in predicting short-term mortality and the need for intubation in the emergency department for patients with sepsis and septic shock. However, it is recommended that the HOTEL score be used in combination with other clinical parameters rather than alone. In particular, clinical parameters such as loss of independence appear to contribute significantly to the predictive power of the score. Future studies should focus on modifying the HOTEL score and evaluating its utility in different patient populations and larger sample sizes.