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
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Publicado: Nature Portfolio 2020
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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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