SPEED is an acromym for Sepsis Patient Evaluation in the Emergency Department.
Patient selection: septic patient in the Emergency Department
Outcome: 28-day mortality rate
Parameters:
(1) immunosuppressed state
(2) hypotension (systolic blood pressure < 90 mm Hg)
(3) hypothermia (body temperature < 36.0°C)
(4) hypoxemia (oxygen saturation < 90%)
(5) low hematocrit (anemia; less than 38 percent)
(6) elevated blood lactate (> 2.4 mmol/L)
(7) pneumonia as the source of infection
(8) acidosis (pH < 7.35)
|
Parameter
|
Finding
|
Points
|
|
immunosuppressed status
|
no
|
0
|
|
|
yes
|
3
|
|
hypotension
|
no
|
0
|
|
|
yes
|
3
|
|
hypothermia
|
no
|
0
|
|
|
yes
|
3
|
|
hypoxemia
|
no
|
0
|
|
|
yes
|
2
|
|
low hematocrit
|
no
|
0
|
|
|
yes
|
2
|
|
elevated blood lactate
|
no
|
0
|
|
|
yes
|
2
|
|
pneumonia
|
no
|
0
|
|
|
yes
|
2
|
|
acidosis
|
no
|
0
|
|
|
yes
|
1
|
total score =
SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the 28-day mortality rate.
|
Score
|
Mortality Rate
|
|
0 to 3
|
11%
|
|
4 to 6
|
30%
|
|
7 to 9
|
57%
|
|
>= 10
|
94%
|
Performance:
• The area under the ROC curve is 0.81.
