The utility of the rapid emergency medicine score (REMS) compared with SIRS, qSOFA and NEWS for Predicting in-hospital Mortality among Patients with suspicion of Sepsis in an emergency department

Abstract Background Many early warning scores (EWSs) have been validated to prognosticate adverse outcomes secondary sepsis in the Emergency Department (ED). These EWSs include Systemic Inflammatory Response Syndrome criteria (SIRS), quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score (NEWS). However, Rapid Medicine (REMS) has never for this purpose. We aimed assess compare prognostic utility of REMS with that SIRS, qSOFA NEWS predicting mortality patients suspicion ED. Methods conducted a retrospective study at ED Siriraj Hospital Mahidol University, Thailand. Adult suspected having between August 2018 July 2019 were included. Their calculated. The primary outcome was all-cause in-hospital mortality. 7-day Results A total 1622 included study; 457 (28.2%) died hospital discharge. yielded highest discrimination capacity (the area under receiver operator characteristics curves (AUROC) 0.62 (95% confidence interval (CI) 0.59, 0.65)), which significantly higher than (AUROC 0.58 (95%CI 0.55, 0.60); p = 0.005) SIRS 0.52 0.49, 0.55); < 0.001) but not superior 0.61 0.58, 0.64); 0.27). best EWS terms calibration association outcome. It could also provide net benefit from decision curve analysis. Comparison plus baseline risk model showed similar results. performed better other Conclusion an score accuracy sepsis-related (qSOFA SIRS), NEWS, had compared presenting sepsis.