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Outcome prediction using the Mortality in Emergency Department Sepsis score combined with procalcitonin for influenza patients

tetano

Editor, Senior Moderator
Med Clin (Barc). 2019 Jun 4. pii: S0025-7753(19)30250-7. doi: 10.1016/j.medcli.2019.03.021. [Epub ahead of print]
[h=1]Outcome prediction using the Mortality in Emergency Department Sepsis score combined with procalcitonin for influenza patients.[/h] [Article in English, Spanish]
Teng F[SUP]1[/SUP], Wan TT[SUP]1[/SUP], Guo SB[SUP]2[/SUP], Liu X[SUP]1[/SUP], Cai JF[SUP]1[/SUP], Qi X[SUP]1[/SUP], Liu WX[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Severe influenza is often associated with bacterial coinfection and can trigger sepsis, which increases the severity, complexity and mortality of the disease. To determine an effective method for predicting 28-day mortality of emergency department (ED) patients with influenza, we investigated the Mortality in Emergency Department Sepsis (MEDS) score, procalcitonin (PCT) and other relevant biomarkers.
[h=4]METHODS:[/h] We conducted a retrospective, observational, monocentric study, and the endpoint was 28-day mortality. Independent predictors were identified and a new combination predictive model was created both by logistic regression, and the model was evaluated by a receiver operating characteristic (ROC) curve.
[h=4]RESULTS:[/h] A total of 364 consecutive ED admitted patients with influenza were enrolled and 45 patients died within 28 days. For predicting 28-day mortality, the MEDS score and PCT were independent predictors with adjusted odds ratio of 1.318 (95% CI 1.206-1.439) and 1.038 (95% CI 1.010-1.065), and with AUCs of 0.817 (95% CI 0.756-0.878) and 0.793 (95% CI 0.725-0.861), respectively. The new combination of the MEDS score with PCT significantly improved the efficacy for predicting 28-day mortality with an AUC of 0.857 (95% CI 0.809-0.905), and was superior to the SOFA score with an AUC of 0.837 (95% CI 0.779-0.894).
[h=4]CONCLUSION:[/h] The MEDS score and PCT, especially when combined, perform well for predicting mortality of ED admitted patients with influenza.
Copyright ? 2019 Elsevier Espa?a, S.L.U. All rights reserved.


[h=4]KEYWORDS:[/h] Emergency department; Gripe; Influenza; MEDS score; Mortalidad; Mortality; Procalcitonin; Procalcitonina; Puntuaci?n MEDS; Unidad de urgencias

PMID: 31174861 DOI: 10.1016/j.medcli.2019.03.021
 
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