A Real-Time Prospective Evaluation of the Prognostic Accuracy of SIRS, MEWS, NEWS2 and qSOFA in Predicting ICU Admission and Mortality in an Emergency Department: Implications for Nursing Practice.
Dimitrios Xythalis, Maria Kalafati, Meropi Mpouzika and 7 others
PMID 41504404WHAT IT FOUND
In ED patients with suspected infection, NEWS2 best flagged those who later needed a prolonged ICU stay, while qSOFA best flagged those who died within 28 days.
No score was both good at catching those outcomes and good at avoiding false alarms.
Key findings
01For predicting ICU stay of at least 3 days, NEWS2 was the best score and clearly better than SIRS.
02For predicting 28-day in-hospital mortality, qSOFA was the best score overall, and qSOFA and NEWS2 were better than SIRS and MEWS.
03In patients with comorbidities, adverse outcomes occurred even when NEWS2, MEWS or qSOFA were negative.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one emergency department in Athens, so the results may not transfer to other settings. Only patients assessed within 1 hour of arrival were included, so the scores were not tested in patients triaged later. Missing white blood cell counts in 17.3% of patients were scored as normal for SIRS, which may bias SIRS results. The mortality outcome was in-hospital death within 28 days, so deaths after discharge were not counted. The study did not capture organ support requirements or other intermediate outcomes. Patients were included because a triage physician suspected infection, so the scores were not tested as a first step to create suspicion.
Declared interests
The paper has no funding or conflict-of-interest declaration. It reports that ChatGPT was used in a limited, supervised way for figure rendering and language editing, and that no AI generated scientific content, data, analyses or references.
The easy way to misread this
Do not conclude that any score can diagnose sepsis or that using it will improve outcomes. The study only compared how well four scores predicted ICU stay or death in patients already suspected of infection; it did not test a treatment.