The value of the Mortality in Emergency Department Sepsis (MEDS) score, C reactive protein and lactate in predicting 28-day mortality of sepsis in a Dutch emergency department

Abstract

The MEDS score is an adequate tool for predicting mortality in patients with sepsis in a Dutch internistic ED population. CRP is less useful in this context. Lactate appears to be at least a fair predictor of mortality, but needs to be investigated more systematically in a larger population.

Can we predict mortality in patients with necrotizing fasciitis using conventional scoring systems?

“…It is considered to be more feasible for ED doctors than the other scoring systems because it has fewer parameters. [17] However, we believe that the MEDS scoring system underestimated the mortality rate because of the exclusion of Glasgow coma scale and biochemical parameters such as sodium, potassium, and creatinine levels and because only a small portion of our patients presented with sepsis. Conversely, SOFA focused on the assessment of organ dysfunction and morbidity whereas APACHE II and SAPS II are designed to predict mortality.…”

The Mortality in Emergency Department Sepsis Score as a Predictor of 1-Month Mortality among Adult Patients with Sepsis: Weighing the Evidence

“…The study by Hermans et al demonstrated the superiority of the MEDS score in its discriminative ability for 28-day mortality (AUC = 0.81) when compared to CRP (AUC = 0.68) [23]. Serum lactate, with an AUC = 0.75, seemed to be potentially useful as well but as it was done in less than 15% of the study population, its prognostic value in comparison to the MEDS score remains uncertain [23]. Lee et al found the MEDS score to have the largest AUC in comparison to CRP and PCT for early as well as late mortality [24].…”

“…Three of the four studies evaluated the performance of the MEDS score in comparison to their respective choice of biomarkers as a predictor of mortality [23][24][25] while the remaining one used a modified MEDS score computed from eight variables instead 4 ISRN Emergency Medicine (http://www.heart.org/idc/groups/heart-public/@wcm/@private/@ecc/documents/downloadable/ucm 308199.pdf).…”

“…Three studies defined the 1-month mortality as death occurring within 28 days of ED presentation [23,25,26] while Lee et al subcategorised the outcome measure as (5-day) early and (6-to 30-day) late mortality [24]. In all four studies, the MEDS score performed better than the respective comparators in predicting mortality with an AUC ranging from 0.78 to 0.89 across the studies (Table 4).…”

“…In all four studies, the MEDS score performed better than the respective comparators in predicting mortality with an AUC ranging from 0.78 to 0.89 across the studies (Table 4). The study by Hermans et al demonstrated the superiority of the MEDS score in its discriminative ability for 28-day mortality (AUC = 0.81) when compared to CRP (AUC = 0.68) [23]. Serum lactate, with an AUC = 0.75, seemed to be potentially useful as well but as it was done in less than 15% of the study population, its prognostic value in comparison to the MEDS score remains uncertain [23].…”