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Description

Bewersdorf et al reported the Sepsis Patient Evaluation in the Emergency Department (SPEED) Score for risk stratification of septic patients in the Emergency Department (ED). The authors are from University of Malaya and University Medical Center Utrecht.


Patient selection: sepsis in the ED

 

Outcome: mortality

 

Parameters:

(1) immune status

(2) blood pressure

(3) body temperature

(4) hypoxemia

(5) hematocrit in percent

(6) serum lactate concentration

(7) pneumonia

(8) acidosis

 

Parameter

Finding

Points

immune status

normal

0

 

immunosuppressed

3

blood pressure

normal or high

0

 

hypotension

3

body temperature

normal or high

0

 

hypothermia

3

hypoxemia

absent

0

 

present

2

hematocrit

normal or high

0

 

low (anemic)

2

serum lactate

low

0

 

elevated

2

pneumonia

absent

0

 

present

2

acidosis

absent

0

 

present

1

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 18

• The higher the score the greater the risk of mortality.

 

Total Score

Mortality in Derivation Set

Mortality in Validation Set

0 to 3

11%

7%

4 to 6

30%

25%

7 to 9

57%

50%

10 to 18

92%

72%

 

Performance:

• The area under the ROC curve is 0.83 in the derivation set and 0.80 in the validation set.


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