Risk Stratification of the Potentially Septic Patient in the Emergency Department: The Mortality in the Emergency Department Sepsis (MEDS) Score

Christopher R. Carpenter, Samuel M. Keim, Suneel Upadhye, H. Bryant Nguyen

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Background: The prompt recognition and management of septic patients remains a challenge within the busy Emergency Department (ED). Prognostic screening aids have traditionally required time-delayed laboratory measurements not validated upon the emergency medicine population. Recently, a brief prognostic tool has been derived and subsequently validated in heterogeneous ED populations. Clinical Question: Can a risk-stratification tool predict 1-month mortality in ED patients with suspected infection? Evidence Review: Six studies evaluating the Mortality in the Emergency Department Sepsis (MEDS) score were identified and evaluated. Results: Higher MEDS scores are associated with increasing mortality. MEDS score's short- and long-term prognostic accuracy is superior to other sepsis scales as well as isolated biomarkers C-reactive protein and procalcitonin. MEDS' prognostic accuracy in severe sepsis is inferior to undifferentiated systemic inflammatory response syndrome (SIRS) patients. Conclusion: The MEDS score is an accurate and reliable prognostic tool for 28-day mortality in ED SIRS patients, but may not be optimal for those with severe sepsis.

Original languageEnglish (US)
Pages (from-to)319-327
Number of pages9
JournalJournal of Emergency Medicine
Volume37
Issue number3
DOIs
StatePublished - Oct 1 2009

Keywords

  • clinical decision rules
  • evidence-based medicine
  • sepsis

ASJC Scopus subject areas

  • Emergency Medicine

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