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The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
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 out...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683594/ https://www.ncbi.nlm.nih.gov/pubmed/33230117 http://dx.doi.org/10.1038/s41598-020-77438-8 |
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author | Perman, Sarah M. Mikkelsen, Mark E. Goyal, Munish Ginde, Adit Bhardwaj, Abhishek Drumheller, Byron Sante, S. Cham Agarwal, Anish K. Gaieski, David F. |
author_facet | Perman, Sarah M. Mikkelsen, Mark E. Goyal, Munish Ginde, Adit Bhardwaj, Abhishek Drumheller, Byron Sante, S. Cham Agarwal, Anish K. Gaieski, David F. |
author_sort | Perman, Sarah M. |
collection | PubMed |
description | 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 | Online Article Text |
id | pubmed-7683594 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-76835942020-11-24 The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients Perman, Sarah M. Mikkelsen, Mark E. Goyal, Munish Ginde, Adit Bhardwaj, Abhishek Drumheller, Byron Sante, S. Cham Agarwal, Anish K. Gaieski, David F. Sci Rep Article 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. Nature Publishing Group UK 2020-11-23 /pmc/articles/PMC7683594/ /pubmed/33230117 http://dx.doi.org/10.1038/s41598-020-77438-8 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Perman, Sarah M. Mikkelsen, Mark E. Goyal, Munish Ginde, Adit Bhardwaj, Abhishek Drumheller, Byron Sante, S. Cham Agarwal, Anish K. Gaieski, David F. The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients |
title | 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_short | 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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683594/ https://www.ncbi.nlm.nih.gov/pubmed/33230117 http://dx.doi.org/10.1038/s41598-020-77438-8 |
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