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

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.

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

Based on the sensitivity of REMS score for predicting the morbidity and mortality as compared to NEWS2 in patients with clinical suspicion of sepsis as observed in earlier publications; citing hereby "The utility of the rapid emergency medicine score (REMS) compared with SIRS, qSOFA and NEWS for Predicting in-hospital Mortality among Patients with suspicion of Sepsis in an emergency department" & "NEWS2 Is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department" with 95% confidence level & 15% relative allowable error, minimum sample size comes to 130.