Table 2 Early warning score performance and clinical utility for all-cause in-hospital mortality and mortality within 7 days of admission in patients with suspected sepsis
Discrimination | Calibration | Overall performance | Clinical utility | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Score | AUROC (95%CI) | Hosmer-Lemeshow Test | Scaled Brier Score (%) | Nagelkerke’s R-Square (%) | Score category | Sensitivity (95%CI) | Specificity (95%CI) | PPV (95%CI) | NPV (95%CI) | LR+ (95%CI) | LR- (95%CI) |
In-hospital mortality | |||||||||||
SIRS | 0.524 (0.494, 0.553) | 0.074 | 0.2 | 0.2 | SIRS ≥ 2 | 85.6 (82–88.7) | 19.8 (17.6–22.2) | 29.5 (28.5–30.5) | 77.8 (73.1–81.8) | 1.1 (1.0–1.7) | 0.7 (0.6–0.9) |
qSOFA | 0.577 (0.549, 0.604) | 0.688 | 2.0 | 1.9 | qSOFA ≥ 2 | 45.3 (40.7–50) | 69.0 (66.3–71.7) | 36.4 (33.4–39.6) | 76.3 (74.6–77.9) | 1.5 (1.3–1.7) | 0.8 (0.7–0.9) |
NEWS | 0.606 (0.575, 0.636) | 0.059 | 2.7 | 2.6 | NEWS ≥ 8 | 68.1 (63.7–72.3) | 47.8 (44.9–50.7) | 33.8 (32.0–35.7) | 79.2 (76.7–81.5) | 1.3 (1.2–1.4) | 0.7 (0.6–0.8) |
REMS | 0.623 (0.593, 0.653) | 0.565 | 4.0 | 3.8 | REMS ≥ 9 | 66.5 (62–70.8) | 50.1 (47.2–53) | 34.4 (32.4–36.3) | 79.2 (76.8–81.5) | 1.3 (1.2–1.5) | 0.7 (0.6–0.8) |
Mortality within 7 days of admission | |||||||||||
SIRS | 0.539 (0.504, 0.571) | 0.025 | 0.3 | 0.3 | SIRS ≥ 2 | 88.6 (84.3–92.1) | 19.8 (17.7, 22.0) | 18.7 (18.0–19.5) | 89.2 (85.5–92.1) | 1.1 (1.1–1.2) | 0.6 (0.4–0.8) |
qSOFA | 0.589 (0.556, 0.622) | 0.154 | 1.6 | 1.6 | qSOFA ≥ 2 | 49.3 (43.3–55.3) | 68.5 (65.9–71.0) | 24.6 (22.0–27.3) | 86.6 (85.2–88.0) | 1.6 (1.4–1.8) | 0.7 (0.7–0.8) |
NEWS | 0.625 (0.589, 0.660) | 0.189 | 2.7 | 2.7 | NEWS ≥ 8 | 70.0 (64.3–75.3) | 46.1 (43.4–48.8) | 21.3 (19.8–22.9) | 88.0 (85.9–89.9) | 1.3 (1.2–1.4) | 0.7 (0.5–0.8) |
REMS | 0.645 (0.608, 0.679) | 0.234 | 4.0 | 3.8 | REMS ≥ 10 | 57.5 (51.5–63.4) | 60.8 (58.1–63.4) | 23.4 (21.3–25.7) | 87.3 (85.6–88.8) | 1.5 (1.3–1.7) | 0.7 (0.6–0.8) |