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Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis

BACKGROUND: QuickSOFA, a prognostic score proposed for patients with infection, has shown a poor predictive value in the geriatric population, probably because of the inappropriateness of the Glasgow Coma Scale (GCS) in assessing acute alteration of mental status in older patients. Indeed, the GCS m...

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Autores principales: Remelli, Francesca, Castellucci, Federico, Vitali, Aurora, Mattioli, Irene, Zurlo, Amedeo, Spadaro, Savino, Volpato, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045242/
https://www.ncbi.nlm.nih.gov/pubmed/33849471
http://dx.doi.org/10.1186/s12877-021-02182-1
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author Remelli, Francesca
Castellucci, Federico
Vitali, Aurora
Mattioli, Irene
Zurlo, Amedeo
Spadaro, Savino
Volpato, Stefano
author_facet Remelli, Francesca
Castellucci, Federico
Vitali, Aurora
Mattioli, Irene
Zurlo, Amedeo
Spadaro, Savino
Volpato, Stefano
author_sort Remelli, Francesca
collection PubMed
description BACKGROUND: QuickSOFA, a prognostic score proposed for patients with infection, has shown a poor predictive value in the geriatric population, probably because of the inappropriateness of the Glasgow Coma Scale (GCS) in assessing acute alteration of mental status in older patients. Indeed, the GCS might result chronically low in older patient with pre-existing cognitive disorders. The aim of this study was to develop an alternative quickSOFA (geriatric-quickSOFA), using the presence of delirium, assessed according to DSM-5 criteria, instead of GCS assessment, to predict mortality in hospitalized older patients with sepsis. METHODS: Retrospective observational study in Acute Geriatrics Unit of St. Anna Hospital of Ferrara (Italy). The study enrolled 165 patients hospitalized between 2017 and 2018 with diagnosis of sepsis or septic shock. Demographic, clinical data and 30-day survival were collected for each patient. Based on arterial blood pressure, respiratory rate, and the presence of delirium, geriatric-quickSOFA was calculated at admission. Primary outcome was 30-day mortality. RESULTS: One hundred sixty-five patients were enrolled with a median age of 88 years; 60.6% were men. High quickSOFA score was not significantly correlated neither with in-hospital nor 30-day mortality. High geriatric-qSOFA score was significantly related to both in-hospital (13.3%vs 51.5%, p = 0.0003) and 30-day mortality (30.0%vs 84.3%, p < 0.00001). CONCLUSION: Geriatric-quickSOFA is significantly associate with short-term mortality risk in older patients with sepsis. Geriatric quickSOFA seems to represent a more suitable and useful predictive tool than the traditional quickSOFA in the geriatric population.
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spelling pubmed-80452422021-04-14 Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis Remelli, Francesca Castellucci, Federico Vitali, Aurora Mattioli, Irene Zurlo, Amedeo Spadaro, Savino Volpato, Stefano BMC Geriatr Research Article BACKGROUND: QuickSOFA, a prognostic score proposed for patients with infection, has shown a poor predictive value in the geriatric population, probably because of the inappropriateness of the Glasgow Coma Scale (GCS) in assessing acute alteration of mental status in older patients. Indeed, the GCS might result chronically low in older patient with pre-existing cognitive disorders. The aim of this study was to develop an alternative quickSOFA (geriatric-quickSOFA), using the presence of delirium, assessed according to DSM-5 criteria, instead of GCS assessment, to predict mortality in hospitalized older patients with sepsis. METHODS: Retrospective observational study in Acute Geriatrics Unit of St. Anna Hospital of Ferrara (Italy). The study enrolled 165 patients hospitalized between 2017 and 2018 with diagnosis of sepsis or septic shock. Demographic, clinical data and 30-day survival were collected for each patient. Based on arterial blood pressure, respiratory rate, and the presence of delirium, geriatric-quickSOFA was calculated at admission. Primary outcome was 30-day mortality. RESULTS: One hundred sixty-five patients were enrolled with a median age of 88 years; 60.6% were men. High quickSOFA score was not significantly correlated neither with in-hospital nor 30-day mortality. High geriatric-qSOFA score was significantly related to both in-hospital (13.3%vs 51.5%, p = 0.0003) and 30-day mortality (30.0%vs 84.3%, p < 0.00001). CONCLUSION: Geriatric-quickSOFA is significantly associate with short-term mortality risk in older patients with sepsis. Geriatric quickSOFA seems to represent a more suitable and useful predictive tool than the traditional quickSOFA in the geriatric population. BioMed Central 2021-04-13 /pmc/articles/PMC8045242/ /pubmed/33849471 http://dx.doi.org/10.1186/s12877-021-02182-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Remelli, Francesca
Castellucci, Federico
Vitali, Aurora
Mattioli, Irene
Zurlo, Amedeo
Spadaro, Savino
Volpato, Stefano
Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis
title Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis
title_full Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis
title_fullStr Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis
title_full_unstemmed Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis
title_short Predictive value of geriatric-quickSOFA in hospitalized older people with sepsis
title_sort predictive value of geriatric-quicksofa in hospitalized older people with sepsis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045242/
https://www.ncbi.nlm.nih.gov/pubmed/33849471
http://dx.doi.org/10.1186/s12877-021-02182-1
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