Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection
Abstract Previous studies have shown inconsistent prognostic accuracy for mortality with both quick sequential organ failure assessment (qSOFA) and the systemic inflammatory response syndrome (SIRS) criteria. We aimed to validate the accuracy of qSOFA and the SIRS criteria for predicting in-hospital...
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Nature Portfolio
2021
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oai:doaj.org-article:edd941345d634ae99d39603a24e8de322021-12-02T15:53:46ZQuick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection10.1038/s41598-021-84743-32045-2322https://doaj.org/article/edd941345d634ae99d39603a24e8de322021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84743-3https://doaj.org/toc/2045-2322Abstract Previous studies have shown inconsistent prognostic accuracy for mortality with both quick sequential organ failure assessment (qSOFA) and the systemic inflammatory response syndrome (SIRS) criteria. We aimed to validate the accuracy of qSOFA and the SIRS criteria for predicting in-hospital mortality in patients with suspected infection in the emergency department. A prospective study was conducted including participants with suspected infection who were hospitalised or died in 34 emergency departments in Japan. Prognostic accuracy of qSOFA and SIRS criteria for in-hospital mortality was assessed by the area under the receiver operating characteristic (AUROC) curve. Of the 1060 participants, 402 (37.9%) and 915 (86.3%) had qSOFA ≥ 2 and SIRS criteria ≥ 2 (given thresholds), respectively, and there were 157 (14.8%) in-hospital deaths. Greater accuracy for in-hospital mortality was shown with qSOFA than with the SIRS criteria (AUROC: 0.64 versus 0.52, difference + 0.13, 95% CI [+ 0.07, + 0.18]). Sensitivity and specificity for predicting in-hospital mortality at the given thresholds were 0.55 and 0.65 based on qSOFA and 0.88 and 0.14 based on SIRS criteria, respectively. To predict in-hospital mortality in patients visiting to the emergency department with suspected infection, qSOFA was demonstrated to be modestly more accurate than the SIRS criteria albeit insufficiently sensitive. Clinical Trial Registration: The study was pre-registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000027258).Atsushi ShiraishiSatoshi GandoToshikazu AbeShigeki KushimotoToshihiko MayumiSeitaro FujishimaAkiyoshi HagiwaraYasukazu ShiinoShin-ichiro ShiraishiToru HifumiYasuhiro OtomoKohji OkamotoJunichi SasakiKiyotsugu TakumaKazuma YamakawaYoshihiro HanakiMasahiro HaradaKazuma MorinoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) |
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DOAJ |
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DOAJ |
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EN |
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Medicine R Science Q |
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Medicine R Science Q Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Yasukazu Shiino Shin-ichiro Shiraishi Toru Hifumi Yasuhiro Otomo Kohji Okamoto Junichi Sasaki Kiyotsugu Takuma Kazuma Yamakawa Yoshihiro Hanaki Masahiro Harada Kazuma Morino Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| description |
Abstract Previous studies have shown inconsistent prognostic accuracy for mortality with both quick sequential organ failure assessment (qSOFA) and the systemic inflammatory response syndrome (SIRS) criteria. We aimed to validate the accuracy of qSOFA and the SIRS criteria for predicting in-hospital mortality in patients with suspected infection in the emergency department. A prospective study was conducted including participants with suspected infection who were hospitalised or died in 34 emergency departments in Japan. Prognostic accuracy of qSOFA and SIRS criteria for in-hospital mortality was assessed by the area under the receiver operating characteristic (AUROC) curve. Of the 1060 participants, 402 (37.9%) and 915 (86.3%) had qSOFA ≥ 2 and SIRS criteria ≥ 2 (given thresholds), respectively, and there were 157 (14.8%) in-hospital deaths. Greater accuracy for in-hospital mortality was shown with qSOFA than with the SIRS criteria (AUROC: 0.64 versus 0.52, difference + 0.13, 95% CI [+ 0.07, + 0.18]). Sensitivity and specificity for predicting in-hospital mortality at the given thresholds were 0.55 and 0.65 based on qSOFA and 0.88 and 0.14 based on SIRS criteria, respectively. To predict in-hospital mortality in patients visiting to the emergency department with suspected infection, qSOFA was demonstrated to be modestly more accurate than the SIRS criteria albeit insufficiently sensitive. Clinical Trial Registration: The study was pre-registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000027258). |
| format |
article |
| author |
Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Yasukazu Shiino Shin-ichiro Shiraishi Toru Hifumi Yasuhiro Otomo Kohji Okamoto Junichi Sasaki Kiyotsugu Takuma Kazuma Yamakawa Yoshihiro Hanaki Masahiro Harada Kazuma Morino |
| author_facet |
Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Yasukazu Shiino Shin-ichiro Shiraishi Toru Hifumi Yasuhiro Otomo Kohji Okamoto Junichi Sasaki Kiyotsugu Takuma Kazuma Yamakawa Yoshihiro Hanaki Masahiro Harada Kazuma Morino |
| author_sort |
Atsushi Shiraishi |
| title |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| title_short |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| title_full |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| title_fullStr |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| title_full_unstemmed |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| title_sort |
quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/edd941345d634ae99d39603a24e8de32 |
| work_keys_str_mv |
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1718385546426843136 |