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Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection

PURPOSE: Sepsis-3 is a life-threatening organ dysfunction caused by dysregulated host responses to infection; and defined using the Sepsis-3 criteria, introduced in 2016, however, the criteria need to be validated in specific clinical fields. We investigated mortality prediction and compared the dia...

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Autores principales: Yoon, Jaechul, Kym, Dohern, Hur, Jun, Cho, Yong Suk, Chun, Wook, Yoon, Dogeon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810178/
https://www.ncbi.nlm.nih.gov/pubmed/36595535
http://dx.doi.org/10.1371/journal.pone.0276597
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author Yoon, Jaechul
Kym, Dohern
Hur, Jun
Cho, Yong Suk
Chun, Wook
Yoon, Dogeon
author_facet Yoon, Jaechul
Kym, Dohern
Hur, Jun
Cho, Yong Suk
Chun, Wook
Yoon, Dogeon
author_sort Yoon, Jaechul
collection PubMed
description PURPOSE: Sepsis-3 is a life-threatening organ dysfunction caused by dysregulated host responses to infection; and defined using the Sepsis-3 criteria, introduced in 2016, however, the criteria need to be validated in specific clinical fields. We investigated mortality prediction and compared the diagnostic performance of quick Sequential Organ Failure Assessment (qSOFA), systemic inflammatory response syndrome (SIRS), and burn-specific SIRS (bSIRS) in burn patients. METHODS: This single-center retrospective cohort study examined burn patients in Seoul, Korea during January 2010–December 2020. Overall, 1,391 patients with suspected infection were divided into four sepsis groups using SOFA, qSOFA, SIRS, and burn-specific SIRS. RESULTS: Hazard ratios (HRs) of all unadjusted models were statistically significant; however, the HR (0.726, p = 0.0080.001) in the SIRS ≥2 group is below 1. In the adjusted model, HRs of the SOFA ≥2 (2.426, <0.001), qSOFA ≥2 (7.198, p<0.001), and SIRS ≥2 (0.575, p<0.001) groups were significant. The diagnostic performance of dichotomized qSOFA, SIRS, and bSIRS for sepsis was defined by the Sepsis-3 criteria. The mean onset day was 4.13±2.97 according to Sepsis-3. The sensitivity of SIRS (0.989, 95% confidence interval [CI]: 0.982–0.994) was higher than that of qSOFA (0.841, 95% CI: 0.819–0.861) and bSIRS (0.803, 95% CI: 0.779–0.825). Specificities of qSOFA (0.929, 95% CI: 0.876–0.964) and bSIRS (0.922, 95% CI: 0.868–0.959) were higher than those of SIRS (0.461, 95% CI: 0.381–0.543). CONCLUSION: Sepsis-3 is a good alternative diagnostic tool because it reflects sepsis severity without delaying diagnosis. SIRS showed higher sensitivity than qSOFA and bSIRS and may therefore more adequately diagnose sepsis.
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spelling pubmed-98101782023-01-04 Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection Yoon, Jaechul Kym, Dohern Hur, Jun Cho, Yong Suk Chun, Wook Yoon, Dogeon PLoS One Research Article PURPOSE: Sepsis-3 is a life-threatening organ dysfunction caused by dysregulated host responses to infection; and defined using the Sepsis-3 criteria, introduced in 2016, however, the criteria need to be validated in specific clinical fields. We investigated mortality prediction and compared the diagnostic performance of quick Sequential Organ Failure Assessment (qSOFA), systemic inflammatory response syndrome (SIRS), and burn-specific SIRS (bSIRS) in burn patients. METHODS: This single-center retrospective cohort study examined burn patients in Seoul, Korea during January 2010–December 2020. Overall, 1,391 patients with suspected infection were divided into four sepsis groups using SOFA, qSOFA, SIRS, and burn-specific SIRS. RESULTS: Hazard ratios (HRs) of all unadjusted models were statistically significant; however, the HR (0.726, p = 0.0080.001) in the SIRS ≥2 group is below 1. In the adjusted model, HRs of the SOFA ≥2 (2.426, <0.001), qSOFA ≥2 (7.198, p<0.001), and SIRS ≥2 (0.575, p<0.001) groups were significant. The diagnostic performance of dichotomized qSOFA, SIRS, and bSIRS for sepsis was defined by the Sepsis-3 criteria. The mean onset day was 4.13±2.97 according to Sepsis-3. The sensitivity of SIRS (0.989, 95% confidence interval [CI]: 0.982–0.994) was higher than that of qSOFA (0.841, 95% CI: 0.819–0.861) and bSIRS (0.803, 95% CI: 0.779–0.825). Specificities of qSOFA (0.929, 95% CI: 0.876–0.964) and bSIRS (0.922, 95% CI: 0.868–0.959) were higher than those of SIRS (0.461, 95% CI: 0.381–0.543). CONCLUSION: Sepsis-3 is a good alternative diagnostic tool because it reflects sepsis severity without delaying diagnosis. SIRS showed higher sensitivity than qSOFA and bSIRS and may therefore more adequately diagnose sepsis. Public Library of Science 2023-01-03 /pmc/articles/PMC9810178/ /pubmed/36595535 http://dx.doi.org/10.1371/journal.pone.0276597 Text en © 2023 Yoon et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yoon, Jaechul
Kym, Dohern
Hur, Jun
Cho, Yong Suk
Chun, Wook
Yoon, Dogeon
Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection
title Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection
title_full Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection
title_fullStr Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection
title_full_unstemmed Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection
title_short Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection
title_sort validation of sepsis-3 using survival analysis and clinical evaluation of quick sofa, sirs, and burn-specific sirs for sepsis in burn patients with suspected infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810178/
https://www.ncbi.nlm.nih.gov/pubmed/36595535
http://dx.doi.org/10.1371/journal.pone.0276597
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