External validation of the MISSED score to predict mortality in patients with severe sepsis and septic shock in the emergency department

作者：Ryoo Seung Mok; Ahn Shin^*; Kim Won Young; Lim Kyoung Soo

来源：European Journal of Emergency Medicine, 2015, 22(5): 327-330.

DOI：10.1097/MEJ.0000000000000156

• clinical prediction rule
• emergency medicine
• mortality
• sepsis
• septic shock

ObjectiveThe Mortality in Severe Sepsis in the Emergency Department (MISSED) score was derived to predict in-hospital mortality in septic patients in the emergency department (ED). The present study aimed to validate the MISSED score in patients receiving early goal-directed therapy (EGDT).MethodsData were analyzed from 280 patients who received EGDT in a tertiary center ED in Korea. Age 65 years and above, albumin level 27 g/l or less, and international normalized ratio of at least 1.2 were variables included in the MISSED score.ResultsWith a cutoff point of 5.5, the odds ratio for death was 2.17 (95% confidence interval 1.18-4.02). Mortality rates with MISSED scores of 0,<5.5, and 5.5 were 4.5, 13.4, and 25.2%, respectively. Although the score was less discriminatory in patients who had EGDT commenced in the ED, a MISSED score higher than 5.5 remained significant.ConclusionFurther studies are required to validate the MISSED score in more diverse patients.

• 出版日期2015-10