Prognostic value of the riscc score in the identification of septic patients at risk of complications
Introduction: The identification of septic patients at risk of progression to severe septic syndrome (SSG) is essential. This early recognition is a real challenge for emergency physicians, hence the need to validate prognostic scores. The RISSC score was used to predict the poor prognosis of sepsis but not yet validated in emergency departments (ED).
Objective: To study the prognostic value of the RISSC score in the identification of septic patients at risk of complication in ED.
Material and method:Prospective study over 12 months. Inclusion of patients (age> 18 years) admitted in ED for sepsis and in whom the RISSC score was calculated. Collection of epidemiological, clinical, therapeutic and outcome characteristics. The RISSC score was calculated. The unfavorable evolution was defined by the occurrence of SSG (severe sepsis or septic shock). The occurrence of organ dysfunction defines severe sepsis. The persistence of hypotension (PAS
Results: Inclusion of 247 patients. SSG: n = 23, 28%. Average age = 60 ± 19 years. Sex ratio = 0.76. The RISSC score was calculated in 83 patients. Average RISSC score = 8.4 ± 5.4. The RISSC score was predictive of complication from a cutt-off of 10 with an area under the curve (AUC) at 0.7, 95% CI [0.585 -0.827], p = 0.04. Sensitivity, specificity, PPV and NPV were 52, 73, 42 and 80% respectively. The positive likelihood ratio was 1.92.
Conclusion: The RISSC score allows early identification of septic patients at risk of complication by the emergency physician from a value more than 10.
