scholarly journals COMPARISON OF SIRS CRITERIA, QSOFA SCORE, AND A COMBINATION OF BOTH FOR THE DIAGNOSIS OF SEPSIS AND PREDICTION OF MORTALITY IN HOSPITALIZED ADULT PATIENTS WITH COVID-19

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A511
Author(s):  
Junfeng Xue ◽  
Shraddha Acharya ◽  
Inigo Atienza ◽  
Liyun Liu ◽  
Jeffrey Lederman ◽  
...  
Keyword(s):  
Adult Patients ◽  
Prediction Of Mortality ◽  
Qsofa Score ◽  
Sirs Criteria

scholarly journals Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

2020 ◽  
pp. 1-7
Author(s):  
Ming Li Chia ◽  
Shaun Wen Yang Chan ◽  
Vishal G. Shelat
Keyword(s):  
Diverticular Disease ◽  
Clinical Pathology ◽  
Vermiform Appendix ◽  
Complicated Appendicitis ◽  
Perioperative Outcomes ◽  
Alvarado Score ◽  
Single Center Experience ◽  
Modified Alvarado Score ◽  
Qsofa Score ◽  
Sirs Criteria

<b><i>Introduction:</i></b> Diverticular disease of the vermiform appendix (DDA) has an incidence of 0.004 to 2.1% in appendicectomy specimens. DDA is variably associated with perforation and malignancy. We report a single-center experience of DDA. The primary aim is to validate the association of DDA with complicated appendicitis or malignancy, and the secondary aim is to validate systemic inflammatory response syndrome (SIRS) criteria and quick Sepsis-related Organ Failure Assessment (qSOFA) scores. <b><i>Methods:</i></b> The histopathology reports of 2,305 appendicectomy specimens from January 2011 to December 2015 were reviewed. Acute appendicitis was found in 2,164 (93.9%) specimens. Histology of the remaining 141 (6.1%) patients revealed: normal appendix (<i>n</i> = 110), DDA (<i>n</i> = 22), endometriosis of appendix (<i>n</i> = 6), and an absent appendix (<i>n</i> = 3). Patient demographics, clinical profile, operative data, and perioperative outcomes of DDA patients are studied. Modified Alvarado score, Andersson score, SIRS criteria, and qSOFA scores were retrospectively calculated. <b><i>Results:</i></b> The incidence of DDA was 0.95%. Ten patients (45.5%) had diverticulitis. The mean age of DDA patients was 39.5 years (range 23–87), with male preponderance (<i>n</i> = 12, 54.5%). The median Modified Alvarado score was 8 (range 4–9), and the median Andersson score was 5 (range 2–8). Fourteen patients (63.6%) had SIRS, and none had a high qSOFA score. Eight patients (36.4%) had complicated appendicitis (perforation [<i>n</i> = 2] or abscess [<i>n</i> = 6]). Eleven (50%) patients underwent laparoscopic appendicectomy. There were three 30-day readmissions and no mortality. <b><i>Conclusion:</i></b> DDA is a distinct clinical pathology associated with complicated appendicitis.

scholarly journals Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Christian Koch ◽  
Fabian Edinger ◽  
Tobias Fischer ◽  
Florian Brenck ◽  
Andreas Hecker ◽  
...  
Keyword(s):  
Intensive Care ◽  
Sofa Score ◽  
Mortality Prediction ◽  
Adequate Treatment ◽  
Suspected Infection ◽  
Intensive Care Patients ◽  
Retrospective Data Analysis ◽  
Surgical Icu ◽  
Qsofa Score ◽  
Sirs Criteria

Abstract Background It is crucial to rapidly identify sepsis so that adequate treatment may be initiated. Accordingly, the Sequential Organ Failure Assessment (SOFA) and the quick SOFA (qSOFA) scores are used to evaluate intensive care unit (ICU) and non-ICU patients, respectively. As demand for ICU beds rises, the intermediate care unit (IMCU) carries greater importance as a bridge between the ICU and the regular ward. This study aimed to examine the ability of SOFA and qSOFA scores to predict suspected infection and mortality in IMCU patients. Methods Retrospective data analysis included 13,780 surgical patients treated at the IMCU, ICU, or both between January 01, 2012, and September 30, 2018. Patients were screened for suspected infection (i.e., the commencement of broad-spectrum antibiotics) and then evaluated for the SOFA score, qSOFA score, and the 1992 defined systemic inflammatory response syndrome (SIRS) criteria. Results Suspected infection was detected in 1306 (18.3%) of IMCU, 1365 (35.5%) of ICU, and 1734 (62.0%) of IMCU/ICU encounters. Overall, 458 (3.3%) patients died (IMCU 45 [0.6%]; ICU 250 [6.5%]; IMCU/ICU 163 [5.8%]). All investigated scores failed to predict suspected infection independently of the analyzed subgroup. Regarding mortality prediction, the qSOFA score performed sufficiently within the IMCU cohort (AUCROC SIRS 0.72 [0.71–0.72]; SOFA 0.52 [0.51–0.53]; qSOFA 0.82 [0.79–0.84]), while the SOFA score was predictive in patients of the IMCU/ICU cohort (AUCROC SIRS 0.54 [0.53–0.54]; SOFA 0.73 [0.70–0.77]; qSOFA 0.59 [0.58–0.59]). Conclusions None of the assessed scores was sufficiently able to predict suspected infection in surgical ICU or IMCU patients. While the qSOFA score is appropriate for mortality prediction in IMCU patients, SOFA score prediction quality is increased in critically ill patients.

scholarly journals Prediction of mortality in adult patients with sepsis using six biomarkers: a systematic review and meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Andreas Pregernig ◽  
Mattia Müller ◽  
Ulrike Held ◽  
Beatrice Beck-Schimmer
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Meta Analysis ◽  
Advanced Glycation Endproducts ◽  
Adult Patients ◽  
Cochrane Library ◽  
Systematic Literature Search ◽  
Prognostic Information ◽  
Prediction Of Mortality ◽  
Mean Differences

Abstract Background Angiopoietin-1 (Ang-1) and 2 (Ang-2), high mobility group box 1 (HMGB1), soluble receptor for advanced glycation endproducts (sRAGE), soluble triggering receptor expressed on myeloid cells 1 (sTREM1), and soluble urokinase-type plasminogen activator receptor (suPAR) have shown promising results for predicting all-cause mortality in critical care patients. The aim of our systematic review and meta-analysis was to assess the prognostic value of these biomarkers for mortality in adult patients with sepsis. Methods A systematic literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases, for articles in English published from 01.01.1990 onwards, was conducted. The systematic review focused exclusively on observational studies of adult patients with sepsis, any randomized trials were excluded. For the meta-analysis, only studies which provide biomarker concentrations within 24 h of admission in sepsis survivors and nonsurvivors were included. Results are presented as pooled mean differences (MD) between nonsurvivors and survivors with 95% confidence interval for each of the six biomarkers. Studies not included in the quantitative analysis were narratively summarized. The risk of bias was assessed in all included studies using the Quality in Prognosis Studies (QUIPS) tool. Results The systematic literature search retrieved 2285 articles. In total, we included 44 studies in the qualitative analysis, of which 28 were included in the meta-analysis. The pooled mean differences in biomarker concentration (nonsurvivors − survivors), measured at onset of sepsis, are listed as follows: (1) Ang-1: − 2.9 ng/ml (95% CI − 4.1 to − 1.7, p < 0.01); (2) Ang-2: 4.9 ng/ml (95% CI 2.6 to 7.1, p < 0.01); (3) HMGB1: 1.2 ng/ml (95% CI 0.0 to 2.4, p = 0.05); (4) sRAGE: 1003 pg/ml (95% CI 628 to 1377, p < 0.01); (5) sTREM-1: 87 pg/ml (95% CI 2 to 171, p = 0.04); (6) suPAR: 5.2 ng/ml (95% CI 4.5 to 6.0, p < 0.01). Conclusions Ang-1, Ang-2, and suPAR provide beneficial prognostic information about mortality in adult patients with sepsis. The further development of standardized assays and the assessment of their performance when included in panels with other biomarkers may be recommended. Trial registration This study was recorded on PROSPERO, prospective register of systematic reviews, under the registration ID: CRD42018081226

Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department

2017 ◽  
Vol 36 (12) ◽  
pp. 2361-2369 ◽  
Author(s):  
J. González del Castillo ◽  
◽  
A. Julian-Jiménez ◽  
F. González-Martínez ◽  
J. Álvarez-Manzanares ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prognostic Accuracy ◽  
Qsofa Score ◽  
Sirs Criteria

scholarly journals Comparison of QSOFA score and SIRS criteria for prediction of sepsis outcome of patients with suspicion of sepsis outside the intensive care unit: A single-center retrospective study

2021 ◽  
Author(s):  
Maryamsadat Mosavi ◽  
lida Mahfoozi
Keyword(s):  
Curve Analysis ◽  
Definite Diagnosis ◽  
Single Center ◽  
Suspected Sepsis ◽  
Failure Assessment ◽  
Invaluable Tool ◽  
Area Under Roc Curve ◽  
Qsofa Score ◽  
Sirs Criteria ◽  
Related Mortality

Abstract Objective:The present study aimed to determine quick Sepsis-related Organ Failure Assessment (qSOFA) in comparison with systemic inflammatory response syndrome (SIRS) in the prediction of the adverse consequences for the suspected sepsis patients outside the ICU.Results:Out of 128 patients with suspected sepsis, 87 (68%) patients were confirmed to have septicemia based on SIRS criteria. The SIRS criteria classified 68% patients as sepsis (87/128), of which 39(44.8%) had positive qSOFA score. The sensitivity and specificity ratios of qSOFA were 44.83% and 80.49%, respectively.ROC curve analysis showed that the area under ROC curve (AUC) of the pSOFA score for predicting the prognosis of sepsis patients were not significantly different. Moreover, regarding the sepsis-related mortality, the area under ROC showed that the qSOFA criteria (score ≥ 2) is suitable for predicting mortality with a sensitivity of 71% and specificity of 72%.Our findings revealed that the qSOFA score was significantly efficient in predicting mortality. However, the SIRS is more sensitive than the qSOFA score in predicting of the definite diagnosis of sepsis. Therefore, the qSOFA score may seem to be an invaluable tool for the identification of sepsis patients at the emergency department.

scholarly journals qSOFA score for prediction of sepsis outcome in emergency department

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Kavous Shahsavarinia ◽  
Payman Moharramzadeh ◽  
Reza Jamal Arvanagi ◽  
Ata Mahmoodpoor
Keyword(s):  
Emergency Department ◽  
Risk Stratification ◽  
Organ Failure ◽  
Task Force ◽  
Warning Signs ◽  
P Value ◽  
International Consensus ◽  
Consensus Definition ◽  
Prediction Of Mortality ◽  
Qsofa Score

Objective: The third international consensus definition for sepsis and septic shock (sepsis 3) task force recently introduced qSOFA (quick sequential organ failure assessment) as a score for detection of patients at risk of sepsis outside of intensive care units. We performed this study to evaluate the validity of qSOFA for early detection and risk stratification of septic patients in emergency department. Methods: We conducted this study in an emergency department of the largest university affiliated hospital in northwest of Iran from Sept 2015 to Sept 2016. One hundred and forty patients who were SIRS positive with a suspected infection without alternative diagnosis and a microbiological proven infection were enrolled in this study. qSOFA was calculated for each patient and correlated with sepsis grades and mortality. Results: From 140 patients 84 (60%) had positive qSOFA score and 56 (40%) patients had negative qSOFA score. Our results showed that near half of patients with positive qSOFA expired during their stay in hospital while this was about 5% for patients with negative qSOFA. ROC curve of study regarding prediction of outcome with qSOFA showed an area under curve of 0.59. (P value: 0.04). Time spent to sepsis detection was 16 minutes shorter with qSOFA score compared to SIRS criteria in this study. Conclusion: In patients with suspected sepsis, qSOFA has acceptable value for risk stratification of severity, multi organ failure and mortality. It seems that education of medical staff and frequent screening of patients for warning signs can help to increase the value of qSOFA in prediction of mortality in critically ill septic patients. doi: https://doi.org/10.12669/pjms.36.4.2031 How to cite this:Shahsavarinia K, Moharramzadeh P, Arvanagi RJ, Mahmoodpoor A. qSOFA score for prediction of sepsis outcome in emergency department. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.2031 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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