Prospective Observational Study to Compare REMS vs NEWS2 for Patients Presenting to the ED With Sepsis

Completed

• Conditions: Sepsis
• Interventions: Drug: Antibiotics, Vasopressors

• Registration Number: NCT07171918
• Lead Sponsor: Jubilee Mission Medical College and Research Institute

Brief Summary

Prospective observational study to determine the utility of Rapid Emergency Medicine Score (REMS) in comparison to National Early Warning Score2 (NEWS2) for predicting morbidity and mortality among patients presenting to the Emergency Department with clinical suspicion of Sepsis

Detailed Description

Rapid Emergency Medicine Score (REMS) is an attenuated version of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and has utility in predicting mortality in non- surgical patients. The NEWS2 can be used on all hospitalized patients to allow for the early detection of clinical deterioration and potential need for higher level of care. NEWS2 is closely associated with sepsis, however REMS is not so. But in recent studies comparing other EWS (Early Warning Scores) of sepsis, REMS was found to be superior.

Hence comparing REMs against NEWS2 to determine prognostication value of both scores in sepsis.

Study Timeline

• Study Start: 2023-01-01
• Study First Submitted: 2023-07-14
• Primary Completion: 2024-06-30
• Study Completion: 2024-12-31
• Status Verified: 2025-09
• Study First Submitted QC: 2025-09-10
• Last Update Submitted: 2025-09-10
• Study First Posted: 2025-09-15
• Last Update Posted: 2025-09-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 130

Inclusion Criteria

• All patients presenting to ED of Tertiary Care Hospital in Thrissur.
• Patients age >/=18 years
• Patients who give informed consent for participation in the study.
• Suspicion of sepsis at the time of presentation to ED as per SSC Guidelines 2021

Exclusion Criteria

• All patients with an alternate diagnosis other than sepsis at the time of discharge.
• Patients referred from other hospitals with diagnosis of sepsis, after initiation of treatment

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Sepsis patients	Antibiotics, Vasopressors	-

Primary Outcome Measures

Name	Time	Method
To determine the utility of REMS score over NEWS2 score - number of days of intensive care.	18 months	To compare REMS score against NEWS2 score with regard to morbidity indicators as - Number of days of intensive care
To determine the utility of REMS score over NEWS2 score - need for vasopressor administration	18 months	To compare REMS score against NEWS2 score with regard to morbidity indicators as - need for vasopressor administration
To determine the utility of REMS score over NEWS2 score - number of days spent as IP	18 months	To compare REMS score against NEWS2 score with regard to morbidity indicators as - number of days spent in hospital
To determine the utility of REMS score over NEWS2 score - need for mechanical ventilation	18 months	To compare REMS score against NEWS2 score with regard to morbidity indicators as - need for mechanical ventilation

Secondary Outcome Measures

Name	Time	Method
To determine in- hospital mortality of patients with clinical suspicion of sepsis	30 days	To compare the effectiveness of REMS and NEWS2 in predicting the in-hospital, 30 day mortality of patients admitted with clinical suspicion of sepsis.
To determine the utility of REMS score over NEWS2 score of patients admitted with qSOFA >/=2	18 months	To compare the utility of REMS score over NEWS2 score for predicting the prognosis of patients admitted with qSOFA \>/= 2 ; serum lactates \>/= 2.

Trial Locations

Locations (1)

Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute; 🇮🇳 Thrissur, India