PIRO, SOFA and MEDS Scores in Predicting One-Month Mortality of Sepsis Patients; a Diagnostic Accuracy Study

Different scoring systems based on clinical and laboratory findings are designed for prediction ofshort-term mortality of patients with severe sepsis and septic shock. This study aimed to compare the screeningperformance characteristics of PIRO, SOFA and MEDS Scores in predicting one-month mortality of sepsis pa-tients.

This diagnostic accuracy study was performed on septic shock and severe sepsis patients refer-ring to emergency department of Loghmane Hakim Hospital, Tehran, Iran, from 2017 to 2018. The performanceof MEDS, SOFA, and PIRO models in predicting 30-day mortality of patients was evaluated using discriminationand calibration indices.

200 patients with the mean age of 71.03±15.59 years were studied (61% male).During the 30 days, 66 patients died (mortality rate=33%). The area under the ROC curve of PIRO, MEDS, andSOFA scores were 0.83 (95% CI=0.78-0.89), 0.94 (95% CI=0.91-0.97) and 0.87 (95% CI=0.81-0.92), respectively.Based on Brier, BrierScaled and Nagelkerke’s R2of the models, the best performance in predicting one-monthmortality belonged to MEDS score. C-statistic showed that MEDS score had the highest value in the differentia-tion between the survived and non-survived cases.

This study showed that MEDS score performsbetter than PIRO and SOFA scores in predicting one-month mortality of patients with severe sepsis and septicshock.