The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients

Abstract The quick sequential organ failure assessment (qSOFA) score has been proposed as a means to rapidly identify adult patients with suspected infection, in pre-hospital, Emergency Department (ED), or general hospital ward locations, who are in a high-risk category with increased likelihood of...

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Autores principales:	Sarah M. Perman, Mark E. Mikkelsen, Munish Goyal, Adit Ginde, Abhishek Bhardwaj, Byron Drumheller, S. Cham Sante, Anish K. Agarwal, David F. Gaieski
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/25b837cea15f4d11b9ef1f77d66402a0
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spelling	oai:doaj.org-article:25b837cea15f4d11b9ef1f77d66402a02021-12-02T16:08:37ZThe sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients10.1038/s41598-020-77438-82045-2322https://doaj.org/article/25b837cea15f4d11b9ef1f77d66402a02020-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-77438-8https://doaj.org/toc/2045-2322Abstract The quick sequential organ failure assessment (qSOFA) score has been proposed as a means to rapidly identify adult patients with suspected infection, in pre-hospital, Emergency Department (ED), or general hospital ward locations, who are in a high-risk category with increased likelihood of “poor outcomes:” a greater than 10% chance of dying or an increased likelihood of spending 3 or more days in the ICU. This score is intended to replace the use of systemic inflammatory response syndrome (SIRS) criteria as a screening tool; however, its role in ED screening and identification has yet to be fully elucidated. In this retrospective observational study, we explored the performance of triage qSOFA (tqSOFA), maximum qSOFA, and first initial serum lactate (> 3 mmol/L) at predicting in-hospital mortality and compared these results to those for the initial SIRS criteria obtained in triage. A total of 2859 sepsis cases were included and the in-hospital mortality rate was 14.4%. The sensitivity of tqSOFA ≥ 2 and maximum qSOFA ≥ 2 to predict in-hospital mortality were 33% and 69%, respectively. For comparison, the triage SIRS criteria and the initial lactate > 3 mmol/L had sensitivities of 82% and 65%, respectively. These results demonstrate that in a large ED sepsis database the earliest measurement of end organ impairment, tqSOFA, performed poorly at identifying patients at increased risk of mortality and maximum qSOFA did not significantly outperform initial serum lactate levels.Sarah M. PermanMark E. MikkelsenMunish GoyalAdit GindeAbhishek BhardwajByron DrumhellerS. Cham SanteAnish K. AgarwalDavid F. GaieskiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sarah M. Perman Mark E. Mikkelsen Munish Goyal Adit Ginde Abhishek Bhardwaj Byron Drumheller S. Cham Sante Anish K. Agarwal David F. Gaieski The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
description	Abstract The quick sequential organ failure assessment (qSOFA) score has been proposed as a means to rapidly identify adult patients with suspected infection, in pre-hospital, Emergency Department (ED), or general hospital ward locations, who are in a high-risk category with increased likelihood of “poor outcomes:” a greater than 10% chance of dying or an increased likelihood of spending 3 or more days in the ICU. This score is intended to replace the use of systemic inflammatory response syndrome (SIRS) criteria as a screening tool; however, its role in ED screening and identification has yet to be fully elucidated. In this retrospective observational study, we explored the performance of triage qSOFA (tqSOFA), maximum qSOFA, and first initial serum lactate (> 3 mmol/L) at predicting in-hospital mortality and compared these results to those for the initial SIRS criteria obtained in triage. A total of 2859 sepsis cases were included and the in-hospital mortality rate was 14.4%. The sensitivity of tqSOFA ≥ 2 and maximum qSOFA ≥ 2 to predict in-hospital mortality were 33% and 69%, respectively. For comparison, the triage SIRS criteria and the initial lactate > 3 mmol/L had sensitivities of 82% and 65%, respectively. These results demonstrate that in a large ED sepsis database the earliest measurement of end organ impairment, tqSOFA, performed poorly at identifying patients at increased risk of mortality and maximum qSOFA did not significantly outperform initial serum lactate levels.
format	article
author	Sarah M. Perman Mark E. Mikkelsen Munish Goyal Adit Ginde Abhishek Bhardwaj Byron Drumheller S. Cham Sante Anish K. Agarwal David F. Gaieski
author_facet	Sarah M. Perman Mark E. Mikkelsen Munish Goyal Adit Ginde Abhishek Bhardwaj Byron Drumheller S. Cham Sante Anish K. Agarwal David F. Gaieski
author_sort	Sarah M. Perman
title	The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
title_short	The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
title_full	The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
title_fullStr	The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
title_full_unstemmed	The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
title_sort	sensitivity of qsofa calculated at triage and during emergency department treatment to rapidly identify sepsis patients
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/25b837cea15f4d11b9ef1f77d66402a0
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The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients

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