Evaluating the Accuracy of the SIL Score for Predicting the  Sepsis Mortality in Emergency Department Triages:  A Comparative Analysis with NEWS and SOFA

Devia Jaramillo, German; Erazo Guerrero,  Lilia; Florez Zuñiga, Natalia; Martin Cuesta, Ronal Mauricio

doi:https://doi.org/10.3390/jcm13247787

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Evaluating the Accuracy of the SIL Score for Predicting the Sepsis Mortality in Emergency Department Triages: A Comparative Analysis with NEWS and SOFA

https://repository.urosario.edu.co/handle/10336/45149
https://doi.org/10.3390/jcm13247787

Autores

Devia Jaramillo, German

Erazo Guerrero, Lilia

Florez Zuñiga, Natalia

Martin Cuesta, Ronal Mauricio

Fecha

2024-12-20

Editor

Journal of Clinical Medicine

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Resumen

El SIL score es una escala que utiliza el índice de shock y el nivel de lactato arterial para identificar precozmente a los pacientes que tienen un alto riesgo de mortalidad intrahospitalaria por sepsis como herramienta temprana en su detección. El score SIL demostro una capacidad superior comparadas con escalas como NEWS y SOFA.

Abstract

Sepsis is a disease with a high mortality rate, which emphasizes the importance of developing tools for the early identification of high-risk patients and to initiate timely treatments to reduce mortality. The SIL score is a scale that uses the shock index and arterial lactate level to identify early on the patients that are at a high risk of in-hospital mortality due to sepsis. The purpose of this study was to validate the SIL score as a tool for estimating the probability of sepsis in-hospital mortality from the triage room in emergency departments. Additionally, the advantages of the SIL score were evaluated in comparison with NEWS and SOFA. Methods: All of the patients with suspected sepsis were prospectively recruited from the triage room in an emergency department. The SIL score, as well as other evaluation scales, were calculated for these patients. The sensitivity, specificity, predictive values, and areas under the curve (AUC) of each scale were assessed to predict mortality. Results: This study included 315 patients. The total mortality of the cohort was 20.4%. Of the total population, 35.5% were in septic shock. The SIL, NEWS, and SOFA scores had similar sensitivities, approximately 60%; however, a higher specificity was documented in the SIL score over the other scales (67%). The SIL score demonstrated superior discriminatory ability compared to the NEWS and SOFA scores (AUC = 0.754, p = 0.01). Conclusions: The SIL score proved to be a useful tool for predicting in-hospital mortality due to sepsis. Its discriminatory ability surpasses that of other evaluated scales. Therefore, the SIL score can be successfully implemented in the triage room of emergency departments to improve the identification and early management of patients with sepsis.