Sivayoham et al reported the REDS score for evaluating a patient with sepsis in the Emergency Department. The score is related to the MISSED score. The authors are from St. George's University Hospitals NHS Trust and Humanitas University.
REDS is an acronym for Risk-stratify Emergency Department suspected Sepsis.
Parameters:
(1) age in years
(2) altered mental status
(3) systolic blood pressure in mm Hg
(4) respiratory rate in breaths per minute
(5) serum lactate in mmol/L
(6) serum albumin in g/L
(7) INR
(8) refractory hypotension (need for vasopressors to maintain the mean arterial pressure above 65 mm Hg after a bolus of 2 liters IV fluid)
|
Parameters |
Findings |
Points |
|
age in years |
< 65 years |
0 |
|
|
>= 65 years |
1 |
|
altered mental status |
no |
0 |
|
|
yes |
1 |
|
systolic blood pressure |
> 100 mm Hg |
0 |
|
|
<= 100 mm Hg |
1 |
|
respiratory rate |
< 22 breaths per minute |
0 |
|
|
>= 22 breaths per minute |
1 |
|
serum lactate |
<= 2 mmol/L |
0 |
|
|
2.1 to 3.9 mmol/L |
1 |
|
|
>= 4 mmol/L |
3 |
|
serum albumin |
<= 27 g/L |
1 |
|
|
> 27 g/L |
0 |
|
INR |
< 1.3 |
0 |
|
|
>= 1.3 |
1 |
|
|
0 |
|
|
refractory hypotension |
no |
0 |
|
|
with lactate <= 2 mmol/L |
2 |
|
|
with lactate > 2 mmol/L |
3 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the mortality.
|
Score |
Mortality Rate in the Derivation Set |
Mortality Rate in Validation Set |
|
0 |
0% |
2.8% |
|
1 |
1.3% |
1.6% |
|
2 |
7% |
6.4% |
|
3 |
13% |
16% |
|
4 |
21% |
9% |
|
5 |
32% |
19% |
|
6 |
26% |
41% |
|
7 |
42% |
38% |
|
8 |
42% |
36% |
|
9 |
25% |
55% |
|
10 |
56% |
0% |
|
11 or 12 |
100% |
100% |
Performance:
• The area under the ROC curve is 0.78.
Specialty: Infectious Diseases, Emergency Medicine
