QSOFA and SOFA scores are valuable tools for predicting postoperative sepsis resulting from ureteroscopic lithotripsy (URSL)

Abstract Purpose The SOFA and qSOFA scores are new tools which are used to assess sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock Task Force. This study aimed to evaluate the feasibility of using the SOFA and qSOFA to predict post-ureteroscopic lithotripsy (URSL) sepsis. Materials and Methods Patients who underwent URSL due to ureteral stone obstruction were retrospectively reviewed using SOFA and qSOFA scores. Patient characteristics including age, gender, comorbidities, American Society of Anesthesiologists Classification (ASA), stone burden, stone location, hydronephrosis status, infectious status, preoperative SOFA and qSOFA score were collected. Preoperative factors were analyzed to determine if they were correlated with postoperative sepsis. Results A total of 830 patients were included in this study, of whom 32 (3.9%) had postoperative sepsis. Multivariate analysis revealed that older age, proximal ureteral stones, severe hydronephrosis, and high preoperative qSOFA or SOFA score were significantly associated with postoperative sepsis. The areas under the curves of a qSOFA score ≥ 1 and SOFA score ≥ 2 for predicting postoperative sepsis were 0.754 and 0.823, respectively. Conclusions Preoperative qSOFA and SOFA scores are convenient and effective for predicting post-URSL sepsis. Further preventive strategies should be performed in these high-risk patients.

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Prognostic Accuracy of SOFA Score and qSOFA as a predictor of mortality among sepsis patients presenting to Emergency Department in one of a tertiary Hospital in Kathmandu, Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v22i1-2.30025 ◽

2020 ◽

Vol 22 (1-2) ◽

pp. 18-21

Author(s):

Sameer Thapa ◽

AR Upreti ◽

R Bajracharya ◽

BK Lingden

Keyword(s):

Emergency Department ◽

Sofa Score ◽

Scoring Systems ◽

Tertiary Hospital ◽

Common Source ◽

Prognostic Accuracy ◽

Source Of Infection ◽

Clinical Scoring ◽

Qsofa Score ◽

Sepsis And Septic Shock

There are many clinical scoring systems that measure the severity in sepsis and septic shock. Therefore, our study aims to calculate prognostic accuracy of commonly used scoring system SOFA and qSOFA in emergency department as a predictor of mortality among sepsis patients.This was prospective observational study conducted in an emergency department for a period of seven months. 156 patients were studied and descriptive statistical analysis was done. The most common source of infection was respiratory. A positive and moderate correlation was seen between initial SOFA score and qSOFA score. The AUC of SOFA score and qSOFA for predicting the mortality were 0.978 and 0.886 with sensitivity of 96.9% and specificty of 57% for SOFA and sensitivity of 96.9% and specificity of 76.1% for qSOFA.SOFA and qSOFA both proved to be similar as a simple prognostic tool with discriminatory capacity in predicting prognosis in septic patient presenting to emergency department.

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qSOFA score for prediction of sepsis outcome in emergency department

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.4.2031 ◽

2020 ◽

Vol 36 (4) ◽

Cited By ~ 1

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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Update on Changing Terminologies in Sepsis

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v36i2.14884 ◽

2016 ◽

Vol 36 (2) ◽

pp. 178-183

Author(s):

Ashish Kumar Simalti ◽

Ranjit Ghuliani ◽

Bindu T. Nair

Keyword(s):

Septic Shock ◽

Critical Care ◽

Intensive Care ◽

Intensive Care Medicine ◽

European Society ◽

Task Force ◽

Critical Care Medicine ◽

International Consensus ◽

The Third ◽

Sepsis And Septic Shock

Definitions of sepsis and septic shock were last revised in 2001. Since then there have been considerable advances in our understanding of pathophysiology, management, and epidemiology of sepsis, suggesting the need for reexamination. The European Society of Intensive Care Medicine and the Society of Critical Care Medicine convened a task force in January 2014 with objective to evaluate and, as needed, update definitions for sepsis and septic shock. Recommendations of this task force were published recently as “The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)”. The aim of this article is to generate awareness and discussion regarding this new important development.

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Combined SuPAR and qSOFA for predicting 28-day mortality in sepsis

10.21203/rs.3.rs-195966/v1 ◽

2021 ◽

Author(s):

Lifeng Wang ◽

Chao Tang ◽

Shuangjun He ◽

Yi Chen ◽

Cuiying Xie

Keyword(s):

Septic Shock ◽

Roc Curve ◽

Area Under The Curve ◽

Enzyme Linked Immunosorbent Assay ◽

Sepsis Severity ◽

International Consensus ◽

Net Reclassification Improvement ◽

Kaplan Meier ◽

Qsofa Score ◽

Sepsis And Septic Shock

Abstract Background and Purpose To determine the prognostic performance of soluble urokinase-type plasminogen activator receptor (suPAR) and quick Sequential Organ Failure Assessment (qSOFA) in predicting the 28-day mortality of sepsis patients admitted to the emergency department (ED). Methods A prospective, single-center observational study was conducted between June 2018 and June 2019. In total, 175 patients with sepsis and septic shock admitted to the ED were enrolled based on the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). We assessed the qSOFA score on ED admission and measured serum suPAR levels by quantitative enzyme-linked immunosorbent assay. Kaplan–Meier survival curves and areas under the receiver operating characteristic (ROC) curve for 28-day mortality were calculated. We estimated category-free net reclassification improvement (NRI) when suPAR was added to qSOFA. Results Increased suPAR levels were significantly associated with 28-day mortality (1337(962–2003) pg/ml in survivors vs. 1742(1238–2514) pg/ml in non-survivors, p = 0.011) and with sepsis severity (1337(986–1979) in sepsis vs. 1742(1215–2649) in septic shock, p = 0.039). Kaplan–Meier curves showed that suPAR ≥ 1382 pg/mL was associated with significantly higher 28-day mortality risk(P = 0.0028). The area under the curve (AUC) for the prediction of 28-day mortality was 0.646 for suPAR, 0.832 for qSOFA, and 0.860 for combined suPAR and qSOFA. Serum suPAR did not significantly increase the AUC of the basic qSOFA, but a model containing suPAR and qSOFA had a continuous NRI of 11% (95% CI :3.5–18.5% ; p = 0.004). Conclusion Serum suPAR is associated with sepsis severity and 28-day mortality. Adding suPAR to qSOFA may increase the ROC curve area and improve predictive value of qSOFA for outcome.

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Analisis Hubungan Sequential Organ Failure Assessment (Sofa) Score Dengan Mortalitas Pasien Sepsis

Jurnal Kesehatan Andalas ◽

10.25077/jka.v9i2.1221 ◽

2020 ◽

Vol 9 (2) ◽

pp. 168

Author(s):

Agustin Iskandar ◽

Fran Siska

Keyword(s):

Septic Shock ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Sofa Score ◽

Area Under The Curve ◽

International Consensus ◽

The Third ◽

Failure Assessment ◽

Sepsis And Septic Shock

Sepsis merupakan kondisi disfungsi organ mengancam nyawa yang diakibatkan oleh disregulasi sistem imun pejamu terhadap infeksi dan Sequential Organ Failure Assessment (SOFA) score merupakan suatu skoring untuk menilai kegagalan organ terkait sepsis. Peningkatan SOFA score diasosiasikan dengan outcome pasien yang lebih buruk. Tujuan: Menganalisis korelasi SOFA score dengan mortalitas pada pasien sepsis. Metode: Desain penelitian adalah kohort prospektif yang dilakukan di RSU Dr Saiful Anwar dari Maret 2018 hingga Juni 2019. Kriteria diagnosis sepsis ditegakkan berdasarkan The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Perhitungan SOFA score dilakukan dalam 2 hari pertama perawatan pasien sepsis di rumah sakit. Analisis data dilakukan pada p < 0,05. Hasil: Didapatkan 85 pasien sepsis dengan luaran meninggal sebanyak 72,94% sedangkan 28,06% membaik. Terdapat perbedaan bermakna antara SOFA score yang meninggal dan yang hidup (p=0,015). SOFA score dipakai untuk memprediksi kematian, didapatkan area under the curve (AUC) 0,74 (p=0,009), dengan cut off point optimum 7. Pada total SOFA score lebih tinggi dari sama dengan 7, didapatkan RR= 3.8, p=0.028. SOFA score merupakan parameter untuk menilai kegagalan organ pada pasien sepsis, dimana total SOFA score yang lebih tinggi dikaitkan dengan peningkatan risiko kematian. Simpulan: SOFA score pada kelompok yang meninggal lebih tinggi daripada yang sembuh. Pasien sepsis dengan SOFA score lebih besar sama dengan 7 memiliki risiko 3,8 kali lebih besar untuk meninggal.Kata kunci: risiko kematian, sepsis, SOFA score

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

Journal of Intensive Care Medicine ◽

10.1177/0885066619894933 ◽

2019 ◽

pp. 088506661989493 ◽

Cited By ~ 1

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.

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Accuracy of SOFA Score to Predict Outcome in Community-Acquired Sepsis

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.04.11555 ◽

2021 ◽

Vol 104 (4) ◽

pp. 544-551

Keyword(s):

Sofa Score ◽

Public Hospital ◽

Predictive Performance ◽

Middle Income ◽

Southern Thailand ◽

Life Threatening ◽

Definition Of ◽

Qsofa Score ◽

Sepsis And Septic Shock ◽

Community Acquired Infection

Background: The new definition of Sepsis-3 defines sepsis as life-threatening organ dysfunction, demonstrated by an increase in the Sequential Organ Failure Assessment (SOFA) of 2 or more points, caused by a dysregulated host response to infection. The performance of SOFA score data in a setting of a tertiary public hospital in a middle-income country remains limited. Objective: To determine the accuracy of the SOFA score to predict the 28-day mortality in community-acquired sepsis patients. Materials and Methods: A retrospective study enrolled community-acquired sepsis and septic shock patients admitted between January and December 2015 in Hatyai Hospital, a tertiary public Hospital in Southern Thailand. All variables for calculating the SOFA and qSOFA scores were collected. The primary outcome was the 28-day mortality. Results: Three hundred seventy-nine patients were enrolled. Eighty-seven patients (23%) died. The median (IQR) SOFA score was 6 (3, 9) points. The SOFA score had a fair predictive performance (AUROC 0.71, 95% CI 0.65 to 0.77), which was higher than qSOFA score (AUROC 0.67, 95% CI 0.62 to 0.73). The SOFA score of 2 points associated with mortality (13%) and higher score patients had an incremental increase mortality rate. The hazard ratio (HR) was 4.59 (95% Cl 1.3 to 15.78, p=0.02) for SOFA Score 6 to 7 points. Conclusion: Among patients presenting with community-acquired infection, the SOFA score indicated the fair predicting ability for the 28-day mortality and performed better than qSOFA score. Keywords: SOFA, qSOFA, Sepsis, Accuracy, Mortality, Community-acquired infection, Thailand

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SEPSIS-3.0 – Ist die Intensivmedizin bereit für die ICD-11?

Der Anaesthesist ◽

10.1007/s00101-021-01012-8 ◽

2021 ◽

Author(s):

Thomas Schmoch ◽

Michael Bernhard ◽

Andrea Becker-Pennrich ◽

Ludwig Christian Hinske ◽

Josef Briegel ◽

...

Keyword(s):

Septic Shock ◽

International Classification Of Diseases ◽

International Consensus ◽

The Third ◽

Failure Assessment ◽

High Care ◽

Classification Of Diseases ◽

Qsofa Score ◽

Sepsis And Septic Shock

Zusammenfassung Hintergrund Im Januar 2022 wird die 11. Revision der International Classification of Diseases (ICD-11) in Kraft treten. Unter anderem wird darin die SEPSIS-3-Definition implementiert sein, in der Sepsis als „lebensbedrohliche Organdysfunktion, hervorgerufen durch eine fehlregulierte Wirtsantwort auf eine Infektion“ definiert wird. Ziel der vorliegenden Sekundärauswertung einer Umfrage zum Thema „Sepsis-induzierte Koagulopathie“ war es zu evaluieren, ob die SEPSIS-3-Definition (engl. The Third International Consensus Definitions for Sepsis and Septic Shock) 4 Jahre nach ihrer internationalen Einführung im klinischen Alltag anästhesiologisch geführter Intensivstationen in Deutschland angekommen ist und so die Voraussetzungen für die Verwendung des ICD-11 gegeben sind. Methoden Im Rahmen einer deutschlandweiten Umfrage unter ärztlichen Leitern von Intensivstationen, die zwischen Oktober 2019 und Mai 2020 durchgeführt wurde, wurde in einem gesonderten Fragenblock nach der verwendeten Sepsisdefinition gefragt. Zusätzlich wurde gefragt, ob der quick-Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) Score zum Screening auf Sepsis in dem Krankenhaus, zu dem die teilnehmende Intensivstation gehört, verwendet wird. Ergebnisse Insgesamt nahmen 50 ärztliche Leiter von anästhesiologisch geführten Intensivbereichen an der Umfrage teil. In Summe gaben die ausgewerteten Intensivstationen an, etwa 14,0 % der in Deutschland registrierten High-Care-Betten zu führen. An 78,9 % der Universitätsklinika und 84,0 % der teilnehmenden Lehrkrankenhäuser ist die SEPSIS-3-Definition im klinischen Alltag integriert. Im Gegensatz dazu wird der Screening-Test „qSOFA“ nur von 26,3 % der teilnehmenden Universitätsklinika, aber immerhin von 52,0 % der Lehrkrankenhäuser und 80,0 % der „sonstigen“ Krankenhäuser verwendet. Schlussfolgerung Unsere Daten zeigen, dass sowohl SEPSIS‑3 als auch qSOFA im klinischen Alltag deutscher Krankenhäuser angekommen sind. Die zurückhaltende Verwendung des qSOFA an Universitätsklinika bei gleichzeitiger breiter Akzeptanz der SEPSIS-3-Definition kann als Indiz interpretiert werden, dass die Suche nach einem geeigneten Screeningtest für Sepsis noch nicht abgeschlossen ist.

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