The quick sequential organ failure assessment (qSOFA) identifies septic patients in the out-of-hospital setting

Background: Recently a multispecialty, multinational task force convened to redefine the criteria for organ dysfunction, sepsis, severe sepsis, and septic shock. The study recommended the quick sequential organ failure assessment (qSOFA) score to identify sepsis patients. The qSOFA is felt to be the initial screen to prompt a more in-depth sepsis workup. This may be particularly true in resource-limited environments such as the prehospital arena. Objectives: The goal of this study was to identify whether emergency medical services (EMS) patients who met all three qSOFA criteria correlated with an emergency department (ED) identification of sepsis. Methods: This was a retrospective chart review of adult patients 1. 18 years of age, meeting qSOFA criteria and presenting to the emergency department between 1/01/2014 and 6/30/2016. Subjects were identified through an electronic query of the EMS record repository. Results: 72 subjects were included in the final analysis. Subjects in the septic group tended to be older with a mean age of 72 years vs 64 years. There was no observed discrepancy relating to gender. 48 of the subjects (67%) were identified as septic and 24 (33%) were identified as non-septic after review of the ED chart. This yielded a positive predictive value of the prehospital qSOFA as 66.67% (95% CI 55.8-77.6). Conclusions: EMS patients with positive qSOFA screens were more likely to be septic upon disposition to the ED. (C) 2018 Elsevier Inc. All rights reserved.