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.
Specialty: Infectious Diseases