Polito et al developed a score that can be used by Emergency Medical Service (EMS) personnel to screen a patient for severe sepsis. A patient at risk for severe sepsis may benefit from more aggressive management. The authors are from Emory University in Atlanta and Northwestern University in Chicago.
Patient selection: sick adult (age >= 18 years) who meet certain screening criteria, including systolic blood pressure < 110 mm Hg
Parameters:
(1) chief concern of EMS personnel
(2) patient origin
(3) age of the patient in years
(4) patient's body temperature by touch
(5) systolic blood pressure in mm Hg
(6) oxygen saturation in percent
|
Parameter |
Finding |
Points |
|
chief concern |
sick patient |
3 |
|
|
other reason |
0 |
|
patient origin |
nursing home |
4 |
|
|
other |
0 |
|
age of the patient |
18 to 39 years |
0 |
|
|
40 to 59 years |
4 |
|
|
>= 60 years |
2 |
|
temperature by touch |
hot to touch |
3 |
|
|
not hot to touch |
0 |
|
systolic blood pressure |
>= 100 mm Hg |
0 |
|
|
90 to 99 mm Hg |
1 |
|
|
80 to 89 mm Hg |
2 |
|
|
70 to 79 mm Hg |
3 |
|
|
60 to 69 mm Hg |
4 |
|
|
< 60 mm Hg |
5 |
|
oxygen saturation |
>= 90% |
0 |
|
|
80 to 89% |
1 |
|
|
70 to 79% |
3 |
|
|
60 to 69% |
4 |
|
|
< 60% |
5 |
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk for severe sepsis.
• A score >= 2 indicates an increased risk for severe sepsis.
Performance"
• The test is performed after the patient has been screened.
• The area under the ROC curve was 0.82-0.84.
• The sensitivity was 86% but the specificity was relatively low at 47%.
Specialty: Infectious Diseases
