Sepsis Code in emergency department: Performance of q-SOFA score compared to SIRS score

被引:3
作者
Boter, Neus Robert [1 ,2 ,3 ]
机构
[1] Hosp Univ Germans Trias Pujol, Med Urgencias, Badalona, Barcelona, Spain
[2] Soc Catalana Urgencies Emergencies Med SOCMUE, Grp trabajo SoCSepsia, Barcelona, Spain
[3] Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
来源
MEDICINA CLINICA | 2022年 / 158卷 / 06期
关键词
Sepsis code; Emergency department; Sepsis; qSOFA; ORGAN FAILURE ASSESSMENT; PROGNOSTIC ACCURACY; MORTALITY; DEFINITIONS; CRITERIA;
D O I
10.1016/j.medcli.2021.03.039
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: The early diagnosis and treatment of sepsis remains a challenge in hospital emergency departments.Objective: The objective was to evaluate the performance of the qSOFA (quick Sequential related Organ Failure Assessment) for activating a Sepsis Code in the emergency department, compared to applying previous criteria based on SIRS (Systemic Inflammatory Response Syndrome).Methods: Patients > 18 years were included who consulted an emergency department of a tertiary hospital over two periods of time (May-October 2015), using SIRS criteria (SIRS Group) and over the same months in 2017 using qSOFA criteria (qSOFA Group).Results: One hundred and five episodes were analysed: 70 corresponded to the SIRS Group and 55 to the qSOFA Group. The groups were comparable in terms of history, with a greater presence of neoplastic disease in the qSOFA Group. No differences were observed in the form of presentation, the action taken in the emergency department, admissions to critical care units, use of vasopressors or mean hospital stay between the two groups. A higher 30-day mortality rate was observed in the qSOFA group (21.81% vs. 4.3%; P = .003). In the multivariate study, neoplastic disease was noteworthy as an independent factor of poor prognosis (OR 5.36; P = .01), and activation using the SIRS criteria as a factor of good prognosis (OR .15; P = .021). Conclusions: The activation of the Sepsis Code using qSOFA criteria results in a reduction in detection, with greater associated mortality. Other complementary tools need to be sought for the early detection of sepsis in the emergency department.(c) 2021 Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:260 / 264
页数:5
相关论文
共 17 条
[11]  
Deltell JMM, 2018, EMERGENCIAS, V30, P383
[12]  
Redondo-González A, 2018, REV ESP QUIM, V31, P316
[13]   Activation of a code sepsis in the emergency department is associated with a decrease in mortality [J].
Robert Boter, Neus ;
Modol Deltell, Josep Maria ;
Casas Garcia, Irma ;
Rocamora Blanch, Gemma ;
Llados Beltran, Gemma ;
Carreres Molas, Anna .
MEDICINA CLINICA, 2019, 152 (07) :255-260
[14]   New Sepsis Criteria A Change We Should Not Make [J].
Simpson, Steven Q. ;
City, Kansas .
CHEST, 2016, 149 (05) :1117-1118
[15]  
Singer M, 2016, JAMA-J AM MED ASSOC, V315, P801, DOI 10.1001/jama.2016.0287
[16]   Performance of the quick Sequential (sepsis-related) Organ Failure Assessment score as a prognostic tool in infected patients outside the intensive care unit: a systematic review and meta-analysis [J].
Song, Jae-Uk ;
Sin, Cheol Kyung ;
Park, Hye Kyeong ;
Shim, Sung Ryul ;
Lee, Jonghoo .
CRITICAL CARE, 2018, 22
[17]   Sepsis definitions: time for change [J].
Vincent, Jean-Louis ;
Opal, Steven M. ;
Marshall, John C. ;
Tracey, Kevin J. .
LANCET, 2013, 381 (9868) :774-775