Evaluation of prognostic value of MEDS, MEWS, and CURB-65 criteria and sepsis I and sepsis III criteria in patients with community-acquired infection in emergency department

Beğenen, Maruf; Durak, Vahide Aslıhan; Akalın, Halis; Armağan, Erol

doi:10.1177/1024907919844866

Cited by 3 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All studies were observational in nature, with 17 prospective studies [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and 16 retrospective studies [19,20,[49][50][51][52][53][54][55][56][57][58][59][60][61][62]. Thirty-two studies were single site studies [19,20,[32][33][34][35][36][37][38][39][40][41][43][44][45][46][47][48]…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Twenty-seven studies were of adults [19,, three of children [41,43,51] and three studies included both adults and children [20,52,54]. Specific patient groups studied were patients with COVID-19 [58,61], community acquired infections [33], respiratory distress or dyspnoea [19,36,38], chest pain [19], abdominal pain [19], cancer [48], stroke [46], older ED patients ≥65 years [37,56,59], and trauma patients [52,60,62]. Seven studies purposefully targeted ED patients requiring hospital admission [32,34,45,46,[56][57][58], two studies targeted patients requiring intensive care unit (ICU) admission [55,59], and eight studies targeted patients triaged as having high levels of clinical urgency [35,39,40,42,50,[52][53][54].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The majority of studies of aggregate scoring systems showed that patients who died had higher scores than those who survived and this was the case for MEWS [34,35,37,39,42,45,48,53], NEWS [32,36,40,56,61], NEWS2 [61], NEWS-C [61], qSOFA [33,61], REMS [42,61], GAP [39], BEWS [54], RTS [60] and Novara-COVID scores [58]. One study showed that MEWS progression (increasing scores) was associated with significantly higher 7-and 30-day mortality [59].…”

Section: Track and Trigger Scoringmentioning

confidence: 99%

“…• 48 h (n = 3) [54,57,61] • 5 days (n = 3) [33,36,37], 7 days (n = 3) [57,59,61] • 14 days (n = 1) [33] • 28 days (n = 3) [33,39,57], 30 days (n = 7) [32,36,40,48,49,53,59] • 90 days (n = 1) [36] • Not reported (n = 1) [47] ICU admission (n = 14) Patients admitted to ICU had higher aggregate scores than those not admitted to ICU and this was the case for MEWS [34,35,37,42,45], NEWS [32,40], PEWS on ED arrival [43] and on ED discharge [41,43], BEWS [54] and REMS [42] on ED arrival; NEWS at 1-h of ED care [40] and NEWS at ED discharge [40]. The majority (52.5%) of patients admitted to ICU had MEWS = 2-3 and no patient with MEWS ≥7 was admitted to ICU [52].…”

Section: Track and Trigger Scoringmentioning

confidence: 99%

See 3 more Smart Citations

Systems for recognition and response to deteriorating emergency department patients: a scoping review

Considine

Fry

Curtis

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background Assessing and managing the risk of clinical deterioration is a cornerstone of emergency care, commencing at triage and continuing throughout the emergency department (ED) care. The aim of this scoping review was to assess the extent, range and nature of published research related to formal systems for recognising and responding to clinical deterioration in emergency department (ED) patients. Materials and methods We conducted a scoping review according to PRISMA-ScR guidelines. MEDLINE complete, CINAHL and Embase were searched on 07 April 2021 from their dates of inception. Human studies evaluating formal systems for recognising and responding to clinical deterioration occurring after triage that were published in English were included. Formal systems for recognising and responding to clinical deterioration were defined as: i) predefined patient assessment criteria for clinical deterioration (single trigger or aggregate score), and, or ii) a predefined, expected response should a patient fulfil the criteria for clinical deterioration. Studies of short stay units and observation wards; deterioration during the triage process; system or score development or validation; and systems requiring pathology test results were excluded. The following characteristics of each study were extracted: author(s), year, design, country, aims, population, system tested, outcomes examined, and major findings. Results After removal of duplicates, there were 2696 publications. Of these 33 studies representing 109,066 patients were included: all were observational studies. Twenty-two aggregate scoring systems were evaluated in 29 studies and three single trigger systems were evaluated in four studies. There were three major findings: i) few studies reported the use of systems for recognising and responding to clinical deterioration to improve care of patients whilst in the ED; ii) the systems for recognising clinical deterioration in ED patients were highly variable and iii) few studies reported on the ED response to patients identified as deteriorating. Conclusion There is a need to re-focus the research related to use of systems for recognition and response to deteriorating patients from predicting various post-ED events to their real-time use to improve patient safety during ED care.

show abstract

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Track and Trigger Scoringmentioning

confidence: 99%

Section: Track and Trigger Scoringmentioning

confidence: 99%

See 2 more Smart Citations

Systems for recognition and response to deteriorating emergency department patients: a scoping review

Considine

Fry

Curtis

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

Prognostic accuracy of SOFA, MEWS, and SIRS criteria in predicting the mortality rate of patients with sepsis: A meta‐analysis

Lan,

Zhou,

Chen

et al. 2023

Nursing in Critical Care

View full text Add to dashboard Cite

BackgroundIn recent years, some studies classified patients with sepsis and predicted their mortality by using some evaluation scales. Several studies reported significant differences in the predictive values of several tools, and the non‐uniformity of the cut‐off value.ObjectiveTo determine and compare the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) score, Modified Early Warning Score (MEWS), and Systemic Inflammatory Response Syndrome (SIRS) criteria in predicting the mortality of patients with sepsis.MethodsThis study comprised of systematic literature review and meta‐analysis according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. We searched PubMed, Embase, Web of Science and Cochrane Library databases from their establishment to July 31, 2022. The research articles published in the index journals provide sufficient data (true positive, false positive, true negative, and false negative results) for patients with sepsis. The combined sensitivity and specificity of the 95% confidence interval (CI) were calculated using the bivariate random effect model (BRM). The hierarchical overall subject working characteristics (HSROC) curve was drawn to evaluate the accuracy of the overall prognosis.ResultsData of 55 088 patients from 32 studies were included in this meta‐analysis. SOFA had an intermediate sensitivity of 0.73 (95% CI: 0.67–0.78) and a specificity of 0.70 (0.63–0.76). SIRS criteria had the highest sensitivity of 0.75 (0.66–0.82) and the lowest specificity of 0.40 (0.29–0.52). MEWS had the lowest sensitivity of 0.49 (0.40–0.59) and the highest specificity of 0.82 (0.78–0.86).ConclusionsAmong SOFA, MEWS, and SIRS criteria, SOFA showed moderate sensitivity and specificity for predicting mortality in patients with sepsis, the highest sensitivity of SIRS and the strongest specificity of MEWS for predicting mortality in patients with sepsis. The future research direction is to combine the relevant indicators of MEWS and SIRS to develop a measurement tool with high reliability and validity.Relevance to clinical practiceThe review provides useful insights into the prognostic accuracy of different assessment tools in predicting mortality in sepsis patients, which will help clinicians choose the most appropriate tool for early identification and treatment of sepsis. The findings may also contribute to the development of more accurate and reliable prognostic models for sepsis.

show abstract

Comparative Effectiveness of CURB-65 and qSOFA Scores in Predicting Pneumonia Outcomes: A Systematic Review

Gelaidan,

Almaimani,

Alorfi

et al. 2024

Cureus

View full text Add to dashboard Cite

Pneumonia is a leading cause of hospitalization and mortality worldwide, often progressing to sepsis, making early accurate severity assessment crucial for effective clinical decision-making. This systematic review compares the CURB-65 (confusion, urea, respiratory rate, blood pressure, and age ≥65 years) and qSOFA scoring systems in predicting pneumonia outcomes, including short-term mortality and ICU admission, to provide evidence-based recommendations for their clinical application. A comprehensive search was conducted across multiple databases, including PubMed, Medline, Web of Science, Google Scholar, Cochrane Library, and BMJ Journals, using specific keywords related to pneumonia and the scoring systems. Eligible studies included adult patients diagnosed with community-acquired, hospital-acquired, or healthcare-associated pneumonia (HAP), where CURB-65 or qSOFA scores were calculated within 24 hours of admission. Data extraction focused on study characteristics, patient demographics, and outcome measures, with quantitative synthesis comparing the predictive performance of the two scores. Sensitivity, specificity, and area under the ROC curve (AUC) values were assessed, and potential sources of heterogeneity and publication bias were examined. The analysis included 22 studies with a total of 25,846 participants, revealing varying predictive accuracy across different settings. CURB-65 demonstrated superior sensitivity (76.52%) and AUC (0.747) for mortality prediction, making it a more reliable tool for identifying high-risk pneumonia patients who require intensive management. Conversely, qSOFA exhibited superior specificity (86.08%) and better performance in predicting ICU admissions, with an AUC of 0.714, highlighting its utility in identifying patients who may need critical care interventions. This systematic review underscores the strengths and limitations of both CURB-65 and qSOFA in predicting pneumonia outcomes. While CURB-65 is more effective for mortality prediction, qSOFA excels in predicting ICU admissions. A combined approach leveraging both scoring systems could enhance patient assessment and management. Further research with larger, prospective studies is recommended to validate these findings and optimize the clinical use of CURB-65 and qSOFA in pneumonia management.

show abstract

Evaluation of prognostic value of MEDS, MEWS, and CURB-65 criteria and sepsis I and sepsis III criteria in patients with community-acquired infection in emergency department

Cited by 3 publications

References 31 publications

Systems for recognition and response to deteriorating emergency department patients: a scoping review

Systems for recognition and response to deteriorating emergency department patients: a scoping review

Prognostic accuracy of SOFA, MEWS, and SIRS criteria in predicting the mortality rate of patients with sepsis: A meta‐analysis

Comparative Effectiveness of CURB-65 and qSOFA Scores in Predicting Pneumonia Outcomes: A Systematic Review

Contact Info

Product

Resources

About