SOFA criteria predict infection-related in-hospital mortality in ICU patients better than SIRS criteria and the qSOFA score

2017 ◽  
Vol 22 (6) ◽  
pp. 211-211 ◽  
Author(s):  
Erik Solligård ◽  
Jan Kristian Damås
Keyword(s):  
Hospital Mortality ◽  
Icu Patients ◽  
Qsofa Score ◽  
Sirs Criteria ◽  
Better Than

scholarly journals Comparison of SIRS criteria and qSOFA score for identifying culture-positive sepsis in the emergency department: a prospective cross-sectional multicentre study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e041024
Author(s):  
Lisette Mignot-Evers ◽  
Vivian Raaijmakers ◽  
Gerba Buunk ◽  
Steffie Brouns ◽  
Lorenzo Romano ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hospital Mortality ◽  
Multicentre Study ◽  
Screening Tools ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Icu Admission ◽  
Qsofa Score ◽  
Culture Positive ◽  
Sirs Criteria

ObjectiveTo compare the daily practice of two emergency departments (ED) in the Netherlands, where systemic inflammatory response syndrome (SIRS) criteria and quick Sequential Organ Failure Assessment (qSOFA) score are used differently as screening tools for culture-positive sepsis.DesignA prospective cross-sectional multicentre study.SettingTwo EDs at two European clinical teaching hospitals in the Netherlands.Participants760 patients with suspected infection who met SIRS criteria or had a qualifying qSOFA score who were treated at two EDs in the Netherlands from 1 January to 1 March 2018 were included.MethodsSIRS criteria and qSOFA score were calculated for each patient. The first hospital treated the patients who met SIRS criteria following the worldwide Surviving Sepsis Campaign protocol. At the second hospital, only patients who met the qualifying qSOFA score received this treatment. Therefore, patients could be divided into five groups: (1) SIRS+, qSOFA−, not treated according to protocol (reference group); (2) SIRS+, qSOFA−, treated according to protocol; (3) SIRS+, qSOFA+, treated according to protocol; (4) SIRS−, qSOFA+, not treated according to protocol; (5) SIRS−, qSOFA+, treated according to protocol.Primary and secondary outcome measuresTo prove culture-positive sepsis was present, cultures were used as the primary outcome. Secondary outcomes were in-hospital mortality and intensive care unit (ICU) admission.Results98.9% met SIRS criteria and 11.7% met qSOFA score. Positive predictive values of SIRS criteria and qSOFA score were 41.2% (95% CI 37.4% to 45.2%) and 48.1% (95% CI 37.4% to 58.9%), respectively. HRs were 0.79 (95% CI 0.40 to 1.56, p=0.500), 3.42 (95% CI 1.82 to 6.44, p<0.001), 18.94 (95% CI 2.48 to 144.89, p=0.005) and 4.97 (95% CI 1.44 to 17.16, p=0.011) for groups 2–5, respectively.ConclusionqSOFA score performed as well as SIRS criteria for identifying culture-positive sepsis and performed significantly better for predicting in-hospital mortality and ICU admission. This study shows that SIRS criteria are no longer necessary and recommends qSOFA score as the standard for identifying culture-positive sepsis in the ED.Trial registration numberNL8315.

scholarly journals Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department

2020 ◽  
Author(s):  
Sheng-En Chu ◽  
Chen-June Seak ◽  
Tse‐Hsuan Su ◽  
Chung-Hsien Chaou ◽  
Hsiao-Jung Tseng ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Primary Outcome ◽  
Viral Infections ◽  
Characteristic Curve ◽  
Predictive Performance ◽  
Public Health Issue ◽  
Research Database ◽  
Qsofa Score ◽  
Sirs Criteria

Abstract Background: The seasonal influenza epidemic is an important public health issue worldwide. Early predictive identification of patients with potentially worse outcome is important in the emergency department (ED). Similarly as with bacterial infection, influenza can cause sepsis. This study was conducted to investigate the effectiveness of the Systemic Inflammatory Response Syndrome (SIRS) criteria and the quick Sequential Organ Failure Assessment (qSOFA) score as prognostic predictors for ED patients with influenza.Methods: This single-center, retrospective cohort study investigated data that was retrieved from a hospital-based research database. Adult ED patients (age ≥18 at admission) with laboratory-proven influenza from 2010 to 2016 were included for data analysis. The initial SIRS and qSOFA scores were both collected. The primary outcome was the utility of each score in the prediction of in-hospital mortality. Results: For the study period, 3,561 patients met the study inclusion criteria. The overall in-hospital mortality was 2.7% (95 patients). When the qSOFA scores were 0, 1, 2, and 3, the percentages of in-hospital mortality were 0.6%, 7.2%, 15.9%, and 25%, respectively. Accordingly, the odds ratios (ORs) were 7.72, 11.92, and 22.46, respectively. The sensitivity and specificity was 24% and 96.2%, respectively, when the qSOFA score was ≥2. However, the SIRS criteria showed no significant associations with the primary outcome. The area under the receiver operating characteristic curve (AUC) was 0.864, which is significantly higher than that with SIRS, where the AUC was 0.786 (P < 0.01).Conclusions: The qSOFA score potentially is a useful prognostic predictor for influenza and could be applied in the ED as a risk stratification tool. However, qSOFA may not be a good screening tool for triage because of its poor sensitivity. The SIRS criteria showed poor predictive performance in influenza for mortality as an outcome. Further research is needed to determine the role of these predictive tools in influenza and in other viral infections.

scholarly journals Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sheng-En Chu ◽  
Chen-June Seak ◽  
Tse-Hsuan Su ◽  
Chung-Hsien Chaou ◽  
Hsiao-Jung Tseng ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Prognostic Accuracy ◽  
Qsofa Score ◽  
Sirs Criteria

Sepsis and Septic Shock Definitions in Patients With Cancer Admitted in ICU

2019 ◽  
pp. 088506661989493 ◽  
Author(s):  
Neveux Nathan ◽  
Jean-Paul Sculier ◽  
Lieveke Ameye ◽  
Marianne Paesmans ◽  
Grigoriu Bogdan-Dragos ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hospital Mortality ◽  
Sofa Score ◽  
Patients With Cancer ◽  
Failure Assessment ◽  
Predict Hospital Mortality ◽  
Definition Of ◽  
Qsofa Score ◽  
Sepsis And Septic Shock ◽  
Sirs Criteria

Introduction: In 2016, a new definition of sepsis and septic shock was adopted. Some studies based on the general population demonstrated that the Sequential Organ Failure Assessment (SOFA) score is more accurate than the systemic inflammatory response syndrome (SIRS) criteria to predict hospital mortality of infected patients requiring intensive care. Patients and Method: We have analyzed all the records of patients with cancer admitted for a suspected infection between January 1, 2013, and December 31, 2016, in our oncological intensive care unit (ICU). Sequential Organ Failure Assessment score and quick SOFA (qSOFA) score as well as SIRS criteria were calculated. We analyzed the accuracy of each score to predict hospital mortality in the setting of the new and old definitions of septic shock. Results: Our study includes 241 patients with a solid tumor and 112 with a hematological malignancy. The hospital mortality rate is 37% (68% in patients with septic shock according to the new definition and 60% according to old definition) between 2013 and 2016. To predict hospital mortality, the SOFA score has an area under the receiver operating characteristic curve of 0.74 (95% confidence interval [CI], 0.68-0.79), the qSOFA of 0.65 (95% CI, 0.59-0.70), and the SIRS criteria of 0.58 (95% CI, 0.52-0.63). In multivariate analysis, a higher SOFA score or a higher qSOFA score indicates poor prognosis: odds ratio (OR) per 1-point increase by 1.28 (95% CI, 1.18-1.39) and 1.48 (95% CI, 1.04-2.11), respectively. Complete remission is a good prognostic factor for hospital mortality: OR 0.39 (95% CI, 0.22-0.67). Conclusion: The new definition of sepsis and septic shock is applicable in an ICU oncological population with the same reliability as in the general population. The SOFA score is more accurate than qSOFA and SIRS criteria to predict hospital mortality.

Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit

JAMA ◽  
2017 ◽  
Vol 317 (3) ◽  
pp. 290 ◽  
Author(s):  
Eamon P. Raith ◽  
Andrew A. Udy ◽  
Michael Bailey ◽  
Steven McGloughlin ◽  
Christopher MacIsaac ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Sofa Score ◽  
Suspected Infection ◽  
Prognostic Accuracy ◽  
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.

The Relationship of the ACCP/SCCM Consensus Conference Classification of Sepsis to Mortality and Multiorgan Dysfunction among Medical ICU Patients

1996 ◽  
Vol 11 (6) ◽  
pp. 326-334 ◽  
Author(s):  
Marin H. Kollef ◽  
Paul R. Eisenberg
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Hospital Mortality ◽  
Consensus Conference ◽  
Organ System ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Icu Patients ◽  
Multiorgan Dysfunction

To determine the relation between the proposed ACCP/SCCM Consensus Conference classification of sepsis and hospital outcomes, we conducted a single-center, prospective observational study at Barnes Hospital, St. Louis, MO, an academic tertiary care hospital. A total of 324 consecutive patients admitted to the medical intensive care unit (ICU) were studied for prospective patient surveillance and data collection. The main outcome measures were the number of acquired organ system derangements and hospital mortality. Fifty-seven (17.6%) patients died during the study period. The proposed classifications of sepsis (e.g., systemic inflammatory response syndrome [SIRS], sepsis, severe sepsis, septic shock) correlated with hospital mortality ( r = 0.330; p < 0.001) and development of an Organ System Failure Index (OSFI) of 3 or greater ( r = 0.426; p < 0.001). Independent determinants of hospital mortality for this patient cohort ( p < 0.05) were development of an OSFI of 3 or greater (adjusted odds ratio [AOR], 13.9; 95% confidence interval [CI], 6.4–30.2; p < 0.001); presence of severe sepsis or septic shock (AOR, 2.6; 95% CI, 1.2–5.6; p = 0.002), and an APACHE II score ≥ of 18 or greater (AOR, 2.4; 95% CI, 1.0–5.8; p = 0.045). Intra-abdominal infection (AOR, 19.1; 95% CI, 1.6–230.1; p = 0.011), an APACHE II score ≥ of 18 or greater (AOR, 8.9; 95% CI, 4.2–18.6; p < 0.001), and presence of severe sepsis or septic shock (AOR, 2.9; 95% CI, 1.5–5.4; p = 0.001) were independently associated with development of an OSFI of 3 or greater. These data confirm that acquired multiorgan dysfunction is the most important predictor of mortality among medical ICU patients. In addition, they identify the proposed ACCP/SCCM Consensus Conference classification of sepsis as an additional independent determinant of both hospital mortality and multiorgan dysfunction.

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