{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:24:10Z","timestamp":1788531850040,"version":"build-2803163510"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sepsis remains a leading cause of morbidity and mortality in older adults, and early risk stratification in the emergency department (ED) is essential for optimizing patient management. This study compared the prognostic performance of the Sequential Organ Failure Assessment (SOFA), National Early Warning Score (NEWS), National Early Warning Score\u2013Lactate (NEWS-L), and Sepsis Prediction and Evaluation in the Emergency Department (SPEED) score for predicting 28-day mortality in geriatric patients with sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective, single-center observational diagnostic accuracy study included consecutive patients aged \u2265 65 years who met the Sepsis-3 criteria between November 15, 2023, and November 15, 2024. The primary outcome was 28-day all-cause mortality. Discriminatory performance was evaluated using receiver operating characteristic (ROC) curve analysis, and areas under the ROC curves (AUCs) were compared using the DeLong test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 330 geriatric patients (median age, 79 years) were included, of whom 213 (64.5%) died within 28 days. All four scoring systems demonstrated moderate discriminatory performance. NEWS-L achieved the highest AUC (0.694, 95% CI: 0.635\u20130.753), followed by NEWS (0.679, 95% CI: 0.620\u20130.738), SPEED (0.653, 95% CI: 0.593\u20130.713), and SOFA (0.644, 95% CI: 0.584\u20130.705). Although NEWS-L demonstrated the highest numerical discrimination and SPEED the highest sensitivity, pairwise DeLong comparisons revealed no statistically significant differences among the evaluated scoring systems (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>All evaluated scoring systems demonstrated only moderate prognostic performance for predicting 28-day mortality in geriatric patients with sepsis, and no statistically significant differences were observed among SOFA, NEWS, NEWS-L, and SPEED. These findings suggest that currently available bedside prognostic tools may have limited discriminatory ability in older adults and highlight the need for the development and external validation of geriatric-specific prognostic models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10815589261483680","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T06:24:23Z","timestamp":1787379863000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic accuracy of SPEED, NEWS, and NEWS-L for predicting 28-day mortality in geriatric sepsis: A prospective study"],"prefix":"10.1177","author":[{"given":"Orhan","family":"\u0130naltekin","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, \u00dcmraniye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6186-6110","authenticated-orcid":false,"given":"Serdar","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, \u00dcmraniye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Ibarz M Haas LEM Ceccato A et al. The critically ill older patient with sepsis: a narrative review. Ann Intensive Care 2024; 14(1): 6. https:\/\/doi.org\/10.1186\/s13613-023-01233-7","DOI":"10.1186\/s13613-023-01233-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"\u00d6zdemir S. Evaluation of the rapid emergency medicine score and rapid acute physiology score scoring systems in predicting short-term survival outcomes in geriatric septic shock patients in the emergency department. Am J Emerg Med 2025; 96: 110\u2013115. https:\/\/doi.org\/10.1016\/j.ajem.2025.06.034","DOI":"10.1016\/j.ajem.2025.06.034"},{"key":"e_1_3_2_4_2","unstructured":"Sanguanwit P Yuksen C Khorana J et al. Development of a clinical score for predicting 28-day mortality in geriatric sepsis patients; a cohort study. Arch Acad Emerg Med 2024; 12(1): e56. https:\/\/doi.org\/10.22037\/aaem.v12i1.2269"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"K\u00f6rel\u00e7iner HS \u00d6zdemir S. The role of the HOTEL score in predicting prognosis in patients with sepsis and septic shock in the emergency department. Intern Emerg Med 2025; 21(2): 487\u2013496. https:\/\/doi.org\/10.1007\/s11739-025-04201-0","DOI":"10.1007\/s11739-025-04201-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Sanguanwit P Nilkosit N Yuksen C et al. Temporal validation of the Ramathibodi Older Sepsis Score (ROSS) for predicting 28-day mortality of older sepsis patients in the emergency department. BMC Emerg Med 2025; 25(1): 238. https:\/\/doi.org\/10.1186\/s12873-025-01382-x","DOI":"10.1186\/s12873-025-01382-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"\u00d6zdemir S Altunok \u0130 \u00d6zkan A. Comparison of the predictive power of blood urea nitrogen\/albumin lactate\/albumin and C-reactive protein\/albumin ratios for prognosis of mortality in critically ill geriatric patients in the emergency department. J Emerg Med 2025; 79: 336\u2013348. https:\/\/doi.org\/10.1016\/j.jemermed.2025.08.031","DOI":"10.1016\/j.jemermed.2025.08.031"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Alhamyani AH Alamri MS Aljuaid NW et al. Sepsis in aging populations: a review of risk factors diagnosis and management. Cureus 2024; 16(12): e74973. https:\/\/doi.org\/10.7759\/cureus.74973","DOI":"10.7759\/cureus.74973"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Singer M Deutschman CS Seymour CW et al. The Third International Consensus Definitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315(8): 801\u2013810. https:\/\/doi.org\/10.1001\/jama.2016.0287","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","unstructured":"Bewersdorf JP Hautmann O Kofink D et al. The SPEED (sepsis patient evaluation in the emergency department) score: a risk stratification and outcome prediction tool. 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