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The most commonly used disease severity scores are inappropriate for risk stratification of older emergency department sepsis patients: an observational multi-centre study

Overview of attention for article published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, September 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • Good Attention Score compared to outputs of the same age and source (77th percentile)

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26 X users
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1 Google+ user

Citations

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122 Mendeley
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Title
The most commonly used disease severity scores are inappropriate for risk stratification of older emergency department sepsis patients: an observational multi-centre study
Published in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, September 2017
DOI 10.1186/s13049-017-0436-3
Pubmed ID
Authors

Bas de Groot, Frank Stolwijk, Mats Warmerdam, Jacinta A. Lucke, Gurpreet K. Singh, Mo Abbas, Simon P. Mooijaart, Annemieke Ansems, Laura Esteve Cuevas, Douwe Rijpsma

Abstract

Sepsis recognition in older emergency department (ED) patients is difficult due to atypical symptom presentation. We therefore investigated whether the prognostic and discriminative performance of the five most commonly used disease severity scores were appropriate for risk stratification of older ED sepsis patients (≥70 years) compared to a younger control group (<70 years). This was an observational multi-centre study using an existing database in which ED patients who were hospitalized with a suspected infection were prospectively included. Patients were stratified by age < 70 and ≥70 years. We assessed the association with in-hospital mortality (primary outcome) and the area under the curve (AUC) with receiver operator characteristics of the Predisposition, Infection, Response, Organ dysfunction (PIRO), quick Sequential Organ Failure Assessment (qSOFA), Mortality in ED Sepsis (MEDS), and the Modified and National Early Warning (MEWS and NEWS) scores. In-hospital mortality was 9.5% ((95%-CI); 7.4-11.5) in the 783 included older patients, and 4.6% (3.6-5.7) in the 1497 included younger patients. In contrast to younger patients, disease severity scores in older patients associated poorly with mortality. The AUCs of all disease severity scores were poor and ranged from 0.56 to 0.64 in older patients, significantly lower than the good AUC range from 0.72 to 0.86 in younger patients. The MEDS had the best AUC (0.64 (0.57-0.71)) in older patients. In older and younger patients, the newly proposed qSOFA score (Sepsis 3.0) had a lower AUC than the PIRO score (sepsis 2.0). The prognostic and discriminative performance of the five most commonly used disease severity scores was poor and less useful for risk stratification of older ED sepsis patients.

X Demographics

X Demographics

The data shown below were collected from the profiles of 26 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 122 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 122 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 18 15%
Student > Ph. D. Student 17 14%
Other 14 11%
Student > Master 14 11%
Student > Bachelor 9 7%
Other 21 17%
Unknown 29 24%
Readers by discipline Count As %
Medicine and Dentistry 67 55%
Nursing and Health Professions 7 6%
Agricultural and Biological Sciences 5 4%
Computer Science 4 3%
Immunology and Microbiology 2 2%
Other 9 7%
Unknown 28 23%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 19. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 November 2021.
All research outputs
#1,897,992
of 25,050,563 outputs
Outputs from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#172
of 1,348 outputs
Outputs of similar age
#36,156
of 321,505 outputs
Outputs of similar age from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#7
of 27 outputs
Altmetric has tracked 25,050,563 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,348 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.6. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 321,505 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 77% of its contemporaries.