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Modified Rapid Emergency Medicine Score (mREMS) of Miller et al for Predicting In-Hospital Mortality for a Trauma Patient

Description

Olsson et al developed the Rapid Emergency Medicine Score (REMS) for evaluating nonsurgical patients in the Emergency Department (ED). Miller et al proposed the modified REMS (mREMS) to predict in-hospital mortality for a trauma patient. The authors are from the University of Kansas.


NOTE: The original REMS score was modeled after the rapid acute physiology score (RAPS) of the APACHE II score.

 

Parameters:

(1) age in years

(2) systolic blood pressure in mm Hg

(3) heart rate in beats per minute

(4) respiratory rate in breaths per minute

(5) peripheral oxygen saturation percent

(6) Glasgow coma score (GCS)

 

Parameter

Finding

Points

age in years

<= 44 years of age

0

 

45 - 64 years

1

 

65 - 74 years

3

 

> 74 years

4

systolic blood pressure

>=200

2

 

160-199

1

 

110-159

0

 

90-109

1

 

80-89

2

 

<=79

4

heart rate

> 179 beats per minute

4

 

140 - 179

3

 

110- 139

2

 

70 - 109

0

 

55 - 69

2

 

40- 54

3

 

<= 39

4

respiratory rate

> 49 breaths per minute

4

 

35 - 49

3

 

25 - 34

1

 

12 - 24

0

 

10 - 11

1

 

6 - 9

2

 

<= 5

4

peripheral oxygen saturation

< 75%

4

 

75 - 85%

3

 

86-89%

1

 

> 89%

0

Glasgow coma score

3 or 4

6

 

5, 6 or 7

5

 

8 to 13

2

 

14 or 15

0

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 26

• The higher the score the greater the risk of in-hospital mortality.

 

mREMS Category

Mortality Rate (Table 5)

0-2

0-0.03%

3-5

0.07-0.09%

6-8

0.26-0.43%

9-13

3-5%

14-17

13-23%

18-21

56-77%

22-26

91-94%

 

Performance:

• The area under the ROC curve is 0.97.


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