Performance of illness severity scores to guide disposition of emergency department patients with severe sepsis or septic shock.

Results A total of 47 of 153 patients were admitted to the ICU. Thirty-nine of 106 ward admissions had a ‘do not resuscitate’ status (not included in analysis). Mortality was 1.5 and 21% in patients initially admitted to a ward and the ICU, respectively. Unanticipated transfer from the ward to the ICU occurred in eight of 67 patients, resulting in higher mortality (38%, P = 0.002, false negatives). Nine surviving patients admitted to the ICU for mere observation for less than 1 day were defined as false positives. Sensitivity of clinical judgement and of PIRO score (cut-off 9.5) alone or combined with clinical judgement were 0.92, 0.75 and 0.98, respectively (P < 0.001). For specificity, these were 0.71, 0.56 and 0.40, respectively (P < 0.001).