Prospective Observational Study to Compare REMS vs NEWS2 for Patients Presenting to the ED With Sepsis

N/ACompletedNCT07171918

Jubilee Mission Medical College and Research Institute130 enrolled

Overview

Prospective observational study to determine the utility of Rapid Emergency Medicine Score (REMS) in comparison to National Early Warning Score2 (NEWS2) for predicting morbidity and mortality among patients presenting to the Emergency Department with clinical suspicion of Sepsis

Rapid Emergency Medicine Score (REMS) is an attenuated version of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and has utility in predicting mortality in non- surgical patients. The NEWS2 can be used on all hospitalized patients to allow for the early detection of clinical deterioration and potential need for higher level of care. NEWS2 is closely associated with sepsis, however REMS is not so. But in recent studies comparing other EWS (Early Warning Scores) of sepsis, REMS was found to be superior. Hence comparing REMs against NEWS2 to determine prognostication value of both scores in sepsis.

Study Type

OBSERVATIONAL

Enrollment

130

Conditions

Sepsis

Interventions

Antibiotics, VasopressorsDRUG

Both groups are scored on REMS and NEWS2, and then observed closely for the period of hospital stay with regard to ICU stay duration, ventilator days, vasopressor dependent days and total hospital duration

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All patients presenting to ED of Tertiary Care Hospital in Thrissur. * Patients age \>/=18 years * Patients who give informed consent for participation in the study. * Suspicion of sepsis at the time of presentation to ED as per SSC Guidelines 2021 Exclusion Criteria: * All patients with an alternate diagnosis other than sepsis at the time of discharge. * Patients referred from other hospitals with diagnosis of sepsis, after initiation of treatment

Locations (1)

Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute

Thrissur, India

Outcomes

Primary Outcomes

To determine the utility of REMS score over NEWS2 score - number of days of intensive care.

To compare REMS score against NEWS2 score with regard to morbidity indicators as - Number of days of intensive care

Time frame: 18 months

To determine the utility of REMS score over NEWS2 score - need for vasopressor administration

To compare REMS score against NEWS2 score with regard to morbidity indicators as - need for vasopressor administration

Time frame: 18 months

To determine the utility of REMS score over NEWS2 score - number of days spent as IP

To compare REMS score against NEWS2 score with regard to morbidity indicators as - number of days spent in hospital

Time frame: 18 months

To determine the utility of REMS score over NEWS2 score - need for mechanical ventilation

To compare REMS score against NEWS2 score with regard to morbidity indicators as - need for mechanical ventilation

Time frame: 18 months

Secondary Outcomes

To determine in- hospital mortality of patients with clinical suspicion of sepsis

To compare the effectiveness of REMS and NEWS2 in predicting the in-hospital, 30 day mortality of patients admitted with clinical suspicion of sepsis.

Time frame: 30 days

To determine the utility of REMS score over NEWS2 score of patients admitted with qSOFA >/=2

To compare the utility of REMS score over NEWS2 score for predicting the prognosis of patients admitted with qSOFA \>/= 2 ; serum lactates \>/= 2.

Time frame: 18 months

Data from ClinicalTrials.gov

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