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Cited by 13Sepsis Diagnosis and TreatmentEmergency and Acute Care StudiesInflammation biomarkers and pathways

Performance of NEWS2, RETTS, clinical judgment and the Predict Sepsis screening tools with respect to identification of sepsis among ambulance patients with suspected infection: a prospective cohort study.

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Wallgren, Ulrika M., Sjölin, Jan, Järnbert-Pettersson, Hans, Kurland, Lisa·2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
DOI 10.1186/s13049-021-00958-3PMC PMC8485465
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Abstract

Background: There is little evidence of which sepsis screening tool to use in the ambulance setting. The primary aim of the current study was to compare the performance of NEWS2 (National Early Warning score 2) and RETTS (Rapid Emergency Triage and Treatment System) with respect to identification of sepsis among ambulance patients with clinically suspected infection. The secondary aim was to compare the performance of the novel Predict Sepsis screening tools with that of NEWS2, RETTS and clinical judgment. Methods: Prospective cohort study of 323 adult ambulance patients with clinically suspected infection, transported to hospitals in Stockholm, during 2017/2018. The sensitivity, specificity, and AUC (Area Under the receiver operating Curve) were calculated and compared by using McNemar´s test and DeLong’s test. Results: The prevalence of sepsis in the current study population was 44.6% (144 of 323 patients). No significant difference in AUC was demonstrated between NEWS2 ≥ 5 and RETTS ≥ orange. NEWS2 ≥ 7 demonstrated a significantly greater AUC than RETTS red. The Predict Sepsis screening tools ≥ 2 demonstrated the highest sensitivity (range 0.87–0.91), along with RETTS ≥ orange (0.83), but the lowest specificity (range 0.39–0.49). The AUC of NEWS2 (0.73) and the Predict Sepsis screening tools (range 0.75–0.77) was similar. Conclusions: The results indicate that NEWS2 could be the better alternative for sepsis identification in the ambulance, as compared to RETTS. The Predict Sepsis screening tools demonstrated a high sensitivity and AUCs similar to that of NEWS2. However, these results need to be interpreted with caution as the Predict Sepsis screening tools require external validation. Trial registration: ClinicalTrials.gov, NCT03249597. Registered 15 August 2017—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03249597.

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  • The new model outperforms other more commonly deployed prediction models and clinical prediction scores, such as Systemic Inflammatory Response Syndrome, SOFA, and Quick SOFA.

    “it outperforms other more commonly deployed prediction models21 and clinical prediction scores, such as Systemic Inflammatory Response Syndrome, SOFA, and Quick SOFA.22”

    From Multicenter Prospective Validation of an Updated Proprietary Sepsis Prediction Model (2026) · cites this paper as [21]

    The Results section compares Predict Sepsis tools with NEWS2, RETTS and clinical judgment, but does not compare them with SIRS, SOFA or qSOFA. A search for those named scores found SOFA used to define the sepsis outcome, not as a competing prediction score. Our copy therefore does not establish the attributed outperformance claim. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 30

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Cited by

Sorted by citations

Authors
Wallgren, U. M., Sjölin, J., Järnbert-Pettersson, H., & Kurland, L.
Affiliations
  • Örebro University (SE)
  • Uppsala University (SE)
Corresponding author
Kurland, Lisa
ORCID
Venue
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Publisher
Springer Science and Business Media LLC
Published
2021-09-30
Volume
29
Issue
1
Pages
144-144
ISSN
1757-7241 (ISSN-L)
DOI
10.1186/s13049-021-00958-3
PMC
PMC8485465
OpenAlex
W3201793433
Cited by
13
References
3
Citations by year
2026: 4 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 2
FWCI
1.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Scandinavian Journal of Trauma Resuscitation and Emergency Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Laerdal Foundation for Acute Medicine (.)
  • Falck Foundation (.)
  • Örebro Universitet (.)
  • Örebro University
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
Keywords
sepsis, sepsis screening, ambulance patients, prehospital care, NEWS2, early warning scores, clinical judgment, suspected infection, sensitivity and specificity
MeSH terms
Adult, Ambulances, Humans, Judgment, Prospective Studies, Triage, Sepsis

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