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.
Keywords
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Article info
Publication history
Published online: May 12, 2009
Accepted:
March 24,
2009
Received:
February 26,
2009
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
