{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:56:43Z","timestamp":1783389403303,"version":"3.54.6"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients admitted to hospital with sepsis are at persistent risk of poor outcome after discharge. Many tools are available to risk-stratify sepsis patients for in-hospital mortality. This study aimed to identify the best risk-stratification tool to prognosticate outcome 180\u2009days after admission <jats:italic>via<\/jats:italic> the emergency department (ED) with suspected sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational cohort study was performed of adult ED patients who were admitted after receiving intravenous antibiotics for the treatment of a suspected sepsis, between 1<jats:sup>st<\/jats:sup> March and 31<jats:sup>st<\/jats:sup> August 2019. The Risk-stratification of ED suspected Sepsis (REDS) score, SOFA score, Red-flag sepsis criteria met, NICE high-risk criteria met, the NEWS2 score and the SIRS criteria, were calculated for each patient. Death and survival at 180\u2009days were noted. Patients were stratified in to high and low-risk groups as per accepted criteria for each risk-stratification tool. Kaplan\u2013Meier curves were plotted for each tool and the log-rank test performed. The tools were compared using Cox-proportional hazard regression (CPHR). The tools were studied further in those without the following specified co-morbidities: Dementia, malignancy, Rockwood Frailty score of 6 or more, long-term oxygen therapy and previous do-not-resuscitate orders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1,057 patients studied 146 (13.8%) died at hospital discharge and 284 were known to have died within 180\u2009days. Overall survival proportion was 74.4% at 180\u2009days and 8.6% of the population was censored before 180\u2009days. Only the REDS and SOFA scores identified less than 50% of the population as high-risk. All tools except the SIRS criteria, prognosticated for outcome at 180\u2009days; Log-rank tests between high and low-risk groups were: REDS score <jats:italic>p<\/jats:italic> &amp;lt;\u20090.0001, SOFA score <jats:italic>p<\/jats:italic> &amp;lt;\u20090.0001, Red-flag criteria <jats:italic>p<\/jats:italic> =\u20090.001, NICE high-risk criteria <jats:italic>p<\/jats:italic> =\u20090.0001, NEWS2 score <jats:italic>p<\/jats:italic> =\u20090.003 and SIRS criteria <jats:italic>p<\/jats:italic> =\u20090.98. On CPHR, the REDS [Hazard ratio (HR) 2.54 (1.92\u20133.35)] and SOFA [HR 1.58 (1.24\u20132.03)] scores out-performed the other risk-stratification tools. In patients without the specified co-morbidities, only the REDS score and the SOFA score risk-stratified for outcome at 180\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, all the risk-stratification tools studied were found to prognosticate for outcome at 180\u2009days, except the SIRS criteria. The REDS and SOFA scores outperformed the other tools.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.985444","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T05:53:52Z","timestamp":1678773232000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic performance of the REDS score, SOFA score, NEWS2 score, and the red-flag, NICE high-risk, and SIRS criteria to predict survival at 180 days, in emergency department patients admitted with suspected sepsis \u2013 An observational cohort study"],"prefix":"10.3389","volume":"10","author":[{"given":"Narani","family":"Sivayoham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil 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