Smyth et al reported the SEPSIS score for prehospital identification of a septic adult. This can be used to alert the Emergency Department prior to arrival. The authors are from the University of Warwick, Royal Stoke University Hospital, and affiliated organizations in England.
SEPSIS = screening to enhance prehospital identification of sepsis
Patient selection: adult prior to arrival at the hospital
Parameters:
(1) age in years
(2) respiratory rate
(3) SpO2 in percent
(4) heart rate
(5) systolic blood pressure in mm Hg
(6) Glasgow coma scale
(7) temperature in °C
(8) skin
Parameter
Finding
Points
age in years
< 40 years
0
40 to 60 years
0
> 60 years
1
respiratory rate
< 10 breaths per minute
0
10 to 20 breaths/minute
0
21 to 40 breaths/minute
1
41 to 60 breaths/minute
2
> 60 breaths per minute
0
SpO2
>= 94 percent
0
< 94 percent
1
heart rate
< 60 beats per minute
0
60 to 100 bpm
0
101 to 140 bpm
1
141 to 160 bpm
2
> 160 bpm
0
systolic blood pressure
< 60 mm Hg
0
60 to 99 mm Hg
1
100 to 120 mm Hg
0
121 to 160 mm Hg
0
> 160 mm Hg
-1
Glasgow coma scale
15
0
13 or 14
0
< 13
1
temperature
< 36.6°C
0
36.3 to 37.4°C
0
37.5 to 39.5°C
1
> 39.5°C
2
skin
normal
0
jaundice, pallor, mottling
1
other
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -1
• maximum score: 11
• A score < 3 is associated with low risk of sepsis.
• A score of 5 has a 20% risk of sepsis.
• A score of 6 has a 60% risk of sepsis.
• A score of 8 has an 80% risk of sepsis.
Performance:
• The area under the ROC curve is 0.87 in the derivation and 0.86 in the validation cohorts.
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