Performance of qSOFA, SIRS, and the qSOFA + SIRS combinations for predicting 30-day adverse outcomes in patients with suspected infection; [Leistungsfähigkeit von qSOFA, SIRS und der Kombination qSOFA + SIRS bei der Vorhersage unerwünschter Ergebnisse innerhalb von 30 Tagen bei Patienten mit Infektionsverdacht]

被引：0

作者：

Yeşil O. ^{[1
]}

Pekdemir M. ^{[1
]}

Özturan İ.U. ^{[1
]}

Doğan N.Ö. ^{[1
]}

Yaka E. ^{[1
]}

Yılmaz S. ^{[1
]}

Karadaş A. ^{[1
]}

Pınar S.G. ^{[1
]}

机构：

[1] Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli University, Kabaoğlu, Baki Komsuoğlu bulvarı No:515, Umuttepe, Kocaeli, İzmit

来源：

Medizinische Klinik - Intensivmedizin und Notfallmedizin | 2022年 / 117卷 / 8期

关键词：

Emergency department; Infections; Sepsis; Sequential organ failure assessment score; Systemic inflammatory response syndrome;

D O I：

10.1007/s00063-021-00870-9

中图分类号：

学科分类号：

摘要：

Background: The use of the quick sequential organ failure assessment score (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria to identify patients at high risk for adverse outcomes in the emergency department (ED) remains controversial due to their low predictive performance and lack of supporting evidence. This study aimed to determine the predictive performance of qSOFA, SIRS, and the qSOFA + SIRS combinations for adverse outcomes. Methods: All adult patients admitted to the ED with suspected infection were prospectively included. qSOFA scores ≥ 2, SIRS score ≥ 2 were defined as risk-positive for adverse outcome. Furthermore, combination‑1, which was defined as either qSOFA or SIRS positivity, and combination‑2, which was defined as both qSOFA and SIRS positivity, were also considered as risk-positive for adverse outcome. The predictive performance of qSOFA, SIRS, combination‑1, and combination‑2 for a composite adverse outcome within 30 days, including mortality, intensive care unit (ICU) admission, and non-ICU hospitalization, were determined. Results: A total of 350 patients were included in the analysis. The composite outcome occurred in 211 (60.3%) patients within 30 days: mortality in 84 (24%), ICU admission in 78 (22.3%), and non-ICU hospitalization in 154 (44%). The sensitivity and specificity, respectively, were determined in predicting composite outcome as 0.34 and 0.93 for qSOFA, 0.81 and 0.31 for SIRS, 0.84 and 0.28 for combination‑1, and 0.31 and 0.96 for combination‑2. Conclusion: The study results suggest that qSOFA and combination‑2 could be a useful tool for confirming patients at high risk for adverse outcomes. Although SIRS and combination‑1 could be helpful for excluding high-risk patients, the requirement of white blood cell counts limits their utilization for screening. © 2021, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

引用

页码：623 / 629

页数：6

共 12 条

[1]

Viale P., Tedeschi S., Scudeller L., Et al., Infectious diseases team for the early management of severe sepsis and septic shock in the emergency department, Clin Infect Dis, 65, 8, pp. 1253-1259, (2017)

[2]

Fernando S.M., Tran A., Taljaard M., Et al., Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection, a systematic review and meta-analysis, Ann Intern Med, (2018)

[3]

Liu Y.C., Luo Y.Y., Zhang X., Et al., Quick sequential organ failure assessment as a prognostic factor for infected patients outside the intensive care unit: a systematic review and meta-analysis, Intern Emerg Med, (2019)

[4]

Haydar S., Spanier M., Weems P., Wood S., Strout T., Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis, Am J Emerg Med, 35, 11, pp. 1730-1733, (2017)

[5]

Clinical Research Calculators, (2021)

[6]

Seymour C.W., Liu V.X., Iwashyna T.J., Et al., Assessment of clinical criteria for sepsis for the third international consensus definitions for sepsis and septic shock (sepsis-3), J Am Med Assoc, 315, 8, pp. 762-774, (2016)

[7]

Rudd K.E., Seymour C.W., Aluisio A.R., Et al., Association of the quick sequential (sepsis-related) organ failure assessment (qSOFA) score with excess hospital mortality in adults with suspected infection in low- and middle-income countries, JAMA, (2018)

[8]

Franchini S., Scarallo L., Carlucci M., Cabrini L., Tresoldi M., SIRS or qSOFA? Is that the question? Clinical and methodological observations from a meta-analysis and critical review on the prognostication of patients with suspected sepsis outside the ICU, Intern Emerg Med, 14, 4, pp. 593-602, (2019)

[9]

Luo J., Jiang W., Weng L., Et al., Usefulness of qSOFA and SIRS scores for detection of incipient sepsis in general ward patients: a prospective cohort study, J Crit Care, 51, pp. 13-18, (2019)

[10]

Song J.U., Sin C.K., Park H.K., Shim S.R., Lee J., 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, Crit Care, 22, 1, pp. 1-13, (2018)

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