scholarly journals A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection

2018 ◽  
Vol 46 (12) ◽  
pp. 1923-1933 ◽  
Author(s):  
Oliver C. Redfern ◽  
Gary B. Smith ◽  
David R. Prytherch ◽  
Paul Meredith ◽  
Matthew Inada-Kim ◽  
...  
Keyword(s):  
Organ Failure ◽  
Early Warning ◽  
Early Warning Score ◽  
Icu Patients ◽  
Assessment Score ◽  
Failure Assessment ◽  
National Early Warning Score

scholarly journals Predicción diagnóstica de qSOFA, news y apache II de mortalidad en 28 días de pacientes con sepsis que ingresan al servicio de emergencia del Hospital Edgardo Rebagliati Martins

2020 ◽  
Author(s):  
◽  
Diego Arturo Montero Miranda ◽  
Javier Armando Rivera Morán
Keyword(s):  
Organ Failure ◽  
Early Warning ◽  
Apache Ii ◽  
Early Warning Score ◽  
Failure Assessment ◽  
National Early Warning Score

Introducción: Diferentes escalas de predicción diagnóstica se vienen recomendando y aplicando en diferentes departamentos de emergencia para predecir ciertos resultados de salud, los cuales pueden apoyar y/o mejorar el manejo de pacientes graves. Entre los más empleados están el qSOFA (quickly- Sepsis-related Organ Failure Assessment), una escala validada por el consenso de sepsis-3; la escala inglesa NEWS (National Early Warning Score) y la escala APACHE II (. Sin embargo, en nuestro medio no se ha evaluado su uso y performance en un servicio de emergencia. Objetivo: Valorar el desempeño diagnóstico de las escalas qSOFA, NEWS y APACHE-II en el departamento de emergencia en el Hospital Edgardo Rebagliati Martins (HNERM). Métodos: Estudio de cohorte retrospectivo realizado en un hospital de alta complejidad. La población de estudio comprendió las admisiones al departamento de emergencia en pacientes con sospecha de sepsis. Asimismo, usando tres escalas: qSOFA, NEWS y APACHE II se calculó la exactitud de la predicción diagnóstica comparándolas entre ellas. Resultados: Se incluyeron 112 pacientes, de los cuales fallecieron 16 (14.29 %). Para predecir mortalidad dentro del hospital, se hallaron áreas bajo las curvas (AUC) para las diferentes escalas. APACHE II ≥17 tuvo una sensibilidad de 87.5% y una especificidad de 78.13% (IC 95%: 0.84 - 0.96) con un AUC de 0.9, qSOFA ≥2 con una sensibilidad de 81.25% y especificidad de 68.75% (IC 95%: 0.63 - 0.87) con un AUC de 0.75 y NEWs ≥7 con una sensibilidad de 62.5% y especificidad de 78.13% (IC 95%: 0.56 - 0.86) con un AUC de 0.71. Conclusiones: Las escalas de puntaje qSOFA, NEWS y APACHE II, son adecuados para la predicción diagnóstica de mortalidad en pacientes con diagnóstico de sepsis y es pertinente su uso en los distintos hospitales del Perú.

Prognostic and discriminative accuracy of the quick Sepsis-related Organ Failure Assessment compared with an early warning score: a Danish cohort study

2021 ◽  
pp. emermed-2020-209746
Author(s):  
Lise Skovgaard Svingel ◽  
Merete Storgaard ◽  
Buket Öztürk Esen ◽  
Lotte Ebdrup ◽  
Jette Ahrensberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Organ Failure ◽  
Early Warning ◽  
Predictive Value ◽  
Primary Outcome ◽  
Characteristic Curve ◽  
Early Warning Score ◽  
Icu Admission ◽  
Hospitalised Patients ◽  
Failure Assessment

BackgroundThe clinical benefit of implementing the quick Sepsis-related Organ Failure Assessment (qSOFA) instead of early warning scores (EWS) to screen all hospitalised patients for critical illness has yet to be investigated in a large, multicentre study.MethodsWe conducted a cohort study including all hospitalised patients ≥18 years with EWS recorded at hospitals in the Central Denmark Region during the year 2016. The primary outcome was intensive care unit (ICU) admission and/or death within 2 days following an initial EWS. Prognostic accuracy was examined using sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV). Discriminative accuracy was examined by the area under the receiver operating characteristic curve (AUROC).ResultsAmong 97 332 evaluated patients, 1714 (1.8%) experienced the primary outcome. The qSOFA ≥2 was less sensitive (11.7% (95% CI: 10.2% to 13.3%) vs 25.1% (95% CI: 23.1% to 27.3%)) and more specific (99.3% (95% CI: 99.2% to 99.3%) vs 97.5% (95% CI: 97.4% to 97.6%)) than EWS ≥5. The NPV was similar for the two scores (EWS ≥5, 98.6% (95% CI: 98.6% to 98.7%) and qSOFA ≥2, 98.4% (95% CI: 98.3% to 98.5%)), while the PPV was 15.1% (95% CI: 13.8% to 16.5%) for EWS ≥5 and 22.4% (95% CI: 19.7% to 25.3%) for qSOFA ≥2. The AUROC was 0.72 (95% CI: 0.70 to 0.73) for EWS and 0.66 (95% CI: 0.65 to 0.67) for qSOFA.ConclusionThe qSOFA was less sensitive (qSOFA ≥2 vs EWS ≥5) and discriminatively accurate than the EWS for predicting ICU admission and/or death within 2 days after an initial EWS. This study did not support replacing EWS with qSOFA in all hospitalised patients.

scholarly journals Prognostic Accuracy of the Quick Sequential Organ Failure Assessment Score and National Early Warning Scores in mortality rate of the Non-Traumatic Patients

2021 ◽  
Author(s):  
Kavous Shahsavarinia ◽  
Aydin Mahmoud Alilou ◽  
Sevil Mahmoud Alilou ◽  
Parinaz Mahmoud Alilou ◽  
Afshin Gharekhani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Early Warning ◽  
Demographic Data ◽  
Early Warning Score ◽  
Trauma Patients ◽  
Main Diagnosis ◽  
Cross Sectional ◽  
Failure Assessment

Background: The current study aimed to evaluate the predictive value of mortality in patients admitted to the Intensive Care Unit (ICU) through the emergency department and based on Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS) and NEWS2 criteria. Methods: In this cross-sectional study, all patients referred to the emergency department with a need of admission to ICU for any reason, were evaluated. Demographic data such as age and sex were recorded for data collection. Also, the main diagnosis, length of stay and hospitalization outcome along with data related to qSOFA, NEWS and NEWS2 indices were included in the researcher's checklist. Results: Of 89 included patients, 52 (58.4%) were male and 37 (41.6%) were female, with mean age of 60.25±20.8. Our findings indicated that qSOFA is a good predictor for mortality in non-traumatic patients so that qSOFA has 48% sensitivity and 100% specificity in the diagnosis of mortality in non-trauma patients. NEWS also has a sensitivity of 72% and a specificity of 71.4% in the diagnosis of non-traumatic mortality. And NEWS2 has 72% sensitivity and 78.6% specificity in non-traumatic mortality diagnosis. Conclusion: Our findings suggested that the sensitivity and specificity of qSOFA, NEWS and NEWS2 in predicting the mortality of non-traumatic patients who were admitted in emergency departments and hospitalized in ICU, are high and reliablen.

scholarly journals Prognostic Accuracy of Early Warning Scores for Clinical Deterioration in Patients With COVID-19

2021 ◽  
Vol 7 ◽  
Author(s):  
Ying Su ◽  
Min-jie Ju ◽  
Rong-cheng Xie ◽  
Shen-ji Yu ◽  
Ji-li Zheng ◽  
...  
Keyword(s):  
Organ Failure ◽  
Early Warning ◽  
Scoring System ◽  
Characteristic Curve ◽  
Invasive Mechanical Ventilation ◽  
Clinical Deterioration ◽  
Early Warning Score ◽  
Prognostic Accuracy ◽  
Failure Assessment ◽  
Early Warning Scores

Background: Early Warning Scores (EWS), including the National Early Warning Score 2 (NEWS2) and Modified NEWS (NEWS-C), have been recommended for triage decision in patients with COVID-19. However, the effectiveness of these EWS in COVID-19 has not been fully validated. The study aimed to investigate the predictive value of EWS to detect clinical deterioration in patients with COVID-19.Methods: Between February 7, 2020 and February 17, 2020, patients confirmed with COVID-19 were screened for this study. The outcomes were early deterioration of respiratory function (EDRF) and need for intensive respiratory support (IRS) during the treatment process. The EDRF was defined as changes in the respiratory component of the sequential organ failure assessment (SOFA) score at day 3 (ΔSOFAresp = SOFA resp at day 3–SOFAresp on admission), in which the positive value reflects clinical deterioration. The IRS was defined as the use of high flow nasal cannula oxygen therapy, noninvasive or invasive mechanical ventilation. The performances of EWS including NEWS, NEWS 2, NEWS-C, Modified Early Warning Scores (MEWS), Hamilton Early Warning Scores (HEWS), and quick sepsis-related organ failure assessment (qSOFA) for predicting EDRF and IRS were compared using the area under the receiver operating characteristic curve (AUROC).Results: A total of 116 patients were included in this study. Of them, 27 patients (23.3%) developed EDRF and 24 patients (20.7%) required IRS. Among these EWS, NEWS-C was the most accurate scoring system for predicting EDRF [AUROC 0.79 (95% CI, 0.69–0.89)] and IRS [AUROC 0.89 (95% CI, 0.82–0.96)], while NEWS 2 had the lowest accuracy in predicting EDRF [AUROC 0.59 (95% CI, 0.46–0.720)] and IRS [AUROC 0.69 (95% CI, 0.57–0.81)]. A NEWS-C ≥ 9 had a sensitivity of 59.3% and a specificity of 85.4% for predicting EDRF. For predicting IRS, a NEWS-C ≥ 9 had a sensitivity of 75% and a specificity of 88%.Conclusions: The NEWS-C was the most accurate scoring system among common EWS to identify patients with COVID-19 at risk for EDRF and need for IRS. The NEWS-C could be recommended as an early triage tool for patients with COVID-19.

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