Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Sep 15;12(9):e0184813.
doi: 10.1371/journal.pone.0184813. eCollection 2017.

Rapid Emergency Medicine Score: A novel prognostic tool for predicting the outcomes of adult patients with hepatic portal venous gas in the emergency department

Chen-June Seak  1   2   3   4 , David Hung-Tsang Yen  3   5 , Chip-Jin Ng  1   2 , Yon-Cheong Wong  2   6 , Kuang-Hung Hsu  7   8 , Joanna Chen-Yeen Seak  9 , Hsien-Yi Chen  1   2 , Chen-Ken Seak  9
Affiliations
Multicenter Study

Rapid Emergency Medicine Score: A novel prognostic tool for predicting the outcomes of adult patients with hepatic portal venous gas in the emergency department

Chen-June Seak et al. PLoS One. .

Abstract

Objective: This study aims to evaluate the performance of Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Modified Early Warning Score (MEWS) in ascertaining the severity of illness and predicting the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians (EPs) in risk stratification.

Methods: Data for 66 adult HPVG patients who visited the EDs of 2 research hospitals between October 1999 and April 2016 were analyzed. REMS, RAPS, and MEWS were calculated based on data in the ED, and probability of death was calculated for each patient based on these scores. The ability of REMS, RAPS, and MEWS to predict group mortality was assessed by using receiver operating characteristic (ROC) curve analysis and calibration analysis.

Results: The sensitivity, specificity, and accuracy for each scoring system were 92.1%, 89.3%, and 90.9% for REMS, 86.8%, 82.1%, and 84.8% for RAPS, and 78.9%, 89.3%, and 83.3% for MEWS respectively. In the ROC curve analysis, the areas under the curve for REMS, RAPS, and MEWS were 0.929, 0.877, and 0.856 respectively.

Conclusion: Our study is the largest series performed in a population of adult HPVG patients in the ED. The results from this study demonstrate that REMS is superior in predicting the mortality of these patients compared to RAPS and MEWS. We therefore recommend that REMS be used for outcome prediction and risk stratification of adult HPVG in the ED.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Receiver operating curves for predicting death according to REMS, RAPS, and MEWS.
See this image and copyright information in PMC

References

    1. Wolfe JN, Evans WA. Gas in the portal veins of the liver in infants; a roentgenographic demonstration with postmortem anatomical correlation. Am J Roentgenol Radium Ther Nucl Med. 1955;74:486–8 - PubMed
    1. Monneuse O, Pilleul F, Barth X, Gruner L, Allaouchiche B, Valette PJ, et al. Portal venous gas detected on computed tomography in emergency situations: surgery is still necessary. World J Surg. 2007;31:1065–71 doi: 10.1007/s00268-006-0589-0 - DOI - PubMed
    1. Seak CJ, Hsu KH, Wong YC, Ng CJ, Yen DH, Seak JC, et al. The prognostic factors of adult patients with hepatic portal venous gas in the ED. Am J Emerg Med. 2014;32:972–5 doi: 10.1016/j.ajem.2014.05.016 - DOI - PubMed
    1. Abboud B, El Hachem J, Yazbeck T, Doumit C. Hepatic portal venous gas: physiopathology, etiology, prognosis and treatment. World J Gastroenterol. 2009;15:3585–90 doi: 10.3748/wjg.15.3585 - DOI - PMC - PubMed
    1. Faberman RS, Mayo-Smith WW. Outcome of 17 patients with portal venous gas detected by CT. Am J Roentgenol. 1997;169:1535–8 - PubMed