scholarly journals 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

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.

scholarly journals Predicting mortality in adult patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Prognostic Accuracy ◽  
Clinical Scoring ◽  
Qsofa Score

Abstract Background Sepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED. Methods We performed a systematic search using MEDLINE, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the prognostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. We did not define biomarker cut-off values in advance. Results We included 18 articles in which a total of 35 combinations of biomarkers and clinical scoring systems were studied, of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. Conclusion The studies we found in this systematic review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis. Future studies should focus on clinical scoring systems which require a limited amount of clinical parameters, such as the qSOFA score in combination with a biomarker that is already routinely available in the ED.

scholarly journals Predicting Mortality in Adult Patients With Sepsis in the Emergency Department by Using Combinations of Biomarkers and Clinical Scoring Systems: A Systematic Review.

2021 ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Prognostic Accuracy ◽  
Multiple Biomarkers ◽  
Clinical Scoring

Abstract IntroductionSepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED.MethodsWe performed a systematic search using MEDLINE, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the prognostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. ResultsWe included 18 articles in which a total of 35 combinations of biomarkers and clinical scoring systems were studied, of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. ConclusionThe combination of PCT, IL-6, lactate and the SAPS-2 score had the highest AUC on 1-month mortality in patients with sepsis in the ED. The studies we found in this review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis.

scholarly journals Evaluation of prognostic value of MEDS, MEWS, and CURB-65 criteria and sepsis I and sepsis III criteria in patients with community-acquired infection in emergency department

2019 ◽  
Vol 27 (5) ◽  
pp. 277-285
Author(s):  
Maruf Beğenen ◽  
Vahide Aslihan Durak ◽  
Halis Akalın ◽  
Erol Armağan
Keyword(s):  
Emergency Department ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Sofa Score ◽  
Early Recognition ◽  
Scoring Systems ◽  
Similar Efficacy ◽  
Early Mortality ◽  
Systemic Inflammatory Response ◽  
Sepsis Score

Background: Early and effective treatment of patients with sepsis requires early recognition in emergency department and understanding the severity of the disease. Many studies have been conducted for this purpose, and many of scoring systems have been developed that provide early recognition of these patients and show their severity. Objectives: The aim of this study is to evaluate the efficacy of the scoring systems used to determine the mortality of patients with infections admitted in emergency department. Methods: In all, 400 patients who admitted to Uludağ University Hospital Emergency Department were prospectively included in this study. In addition to Systemic Inflammatory Response Syndrome score, Quick SOFA score, Mortality in Emergency Department Sepsis score, Modified Early Warning Score, and Charlson Comorbidity Index score in all patients, CURB-65 score was calculated in the patients diagnosed with pneumonia. It has been aimed to determine the power of these scores’ predictive mortality rates and their superiority to each other. Results: It was found that Mortality in Emergency Department Sepsis score and Quick SOFA score could be used with similar efficacy (respectively p = 0.761 and p = 0.073) in determining early mortality in emergency department (5th and 14th days) and that MEDS score was more effective (p < 0.001) in predicting the 28th-day mortality. While these recommendations were valid in patients diagnosed with pneumonia, it was determined that CURB-65 score could also be used to estimate 5th-, 14th-, and 28th-day mortalities (respectively, for the 5th day, p = 0.894 and p = 0.256; for the 14th day, p = 0.425 and p = 0.098; and for the 28th day, p = 0.095 and p = 0.158). The power of Systemic Inflammatory Response Syndrome score, previously used to identify sepsis, in predicting mortality was detected to be lower. Conclusion: Mortality in Emergency Department Sepsis score and Quick SOFA score could be used with similar efficacy in determining early mortality in emergency department. However, if you want to predict 28th-day mortality rate, it can be better to use Mortality in Emergency Department Sepsis score or CURB-65 (in patients diagnosed with pneumonia).

scholarly journals The impact of the Sepsis-3 definition on ICU admission of patients with infection

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Jenny Klimpel ◽  
Lorenz Weidhase ◽  
Michael Bernhard ◽  
André Gries ◽  
Sirak Petros
Keyword(s):  
Emergency Department ◽  
Blood Lactate ◽  
Sofa Score ◽  
High Specificity ◽  
Receiver Operating Curve ◽  
Predictive Values ◽  
Icu Admission ◽  
Sepsis Diagnosis ◽  
Qsofa Score ◽  
The Impact

Abstract Background Sepsis is defined as a life-threatening organ dysfunction due to a dysregulated inflammation following an infection. However, the impact of this definition on patient care is not fully clear. This study investigated the impact of the current definition on ICU admission of patients with infection. Methods We performed a prospective observational study over twelve months on consecutive patients presented to our emergency department and admitted for infection. We analyzed the predictive values of the quick sequential organ failure assessment (qSOFA) score, the SOFA score and blood lactate regarding ICU admission. Results We included 916 patients with the diagnosis of infection. Median age was 74 years (IQR 62–82 years), and 56.3% were males. There were 219 direct ICU admissions and 697 general ward admissions. A qSOFA score of ≥2 points had 52.9% sensitivity and 98.3% specificity regarding sepsis diagnosis. A qSOFA score of ≥2 points had 87.2% specificity but only 39.9% sensitivity to predict ICU admission. A SOFA score of ≥2 points had 97.4% sensitivity, but only 17.1% specificity to predict ICU admission, while a SOFA score of ≥4 points predicted ICU admission with 82.6% sensitivity and 71.7% specificity. The area under the receiver operating curve regarding ICU admission was 0.81 (95 CI, 0.77–0.86) for SOFA score, 0.55 (95% CI, 0.48–0.61) for blood lactate, and only 0.34 (95% CI, 0.28–0.40) for qSOFA on emergency department presentation. Conclusions While a positive qSOFA score had a high specificity regarding ICU admission, the low sensitivity of the score among septic patients as well as among ICU admissions considerably limited its value in routine patient management. The SOFA score was the better predictor of ICU admission, while the predictive value of blood lactate was equivocal.

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 Monocyte Distribution Width, Neutrophil-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio Improves Early Prediction for Sepsis at the Emergency

2021 ◽  
Vol 11 (8) ◽  
pp. 732
Author(s):  
Sen-Kuang Hou ◽  
Hui-An Lin ◽  
Shao-Chun Chen ◽  
Chiou-Feng Lin ◽  
Sheng-Feng Lin
Keyword(s):  
Sofa Score ◽  
Scoring Systems ◽  
Neutrophil To Lymphocyte Ratio ◽  
Diagnostic Model ◽  
Platelet To Lymphocyte Ratio ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Early Sepsis ◽  
New Biomarkers ◽  
Qsofa Score

(1) Background: Sepsis is a life-threatening condition, and most patients with sepsis first present to the emergency department (ED) where early identification of sepsis is challenging due to the unavailability of an effective diagnostic model. (2) Methods: In this retrospective study, patients aged ≥20 years who presented to the ED of an academic hospital with systemic inflammatory response syndrome (SIRS) were included. The SIRS, sequential organ failure assessment (SOFA), and quick SOFA (qSOFA) scores were obtained for all patients. Routine complete blood cell testing in conjugation with the examination of new inflammatory biomarkers, namely monocyte distribution width (MDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), was performed at the ED. Propensity score matching was performed between patients with and without sepsis. Logistic regression was used for constructing models for early sepsis prediction. (3) Results: We included 296 patients with sepsis and 1184 without sepsis. A SIRS score of >2, a SOFA score of >2, and a qSOFA score of >1 showed low sensitivity, moderate specificity, and limited diagnostic accuracy for predicting early sepsis infection (c-statistics of 0.660, 0.576, and 0.536, respectively). MDW > 20, PLR > 9, and PLR > 210 showed higher sensitivity and moderate specificity. When we combined these biomarkers and scoring systems, we observed a significant improvement in diagnostic performance (c-statistics of 0.796 for a SIRS score of >2, 0.761 for a SOFA score of >2, and 0.757 for a qSOFA score of >1); (4) Conclusions: The new biomarkers MDW, NLR, and PLR can be used for the early detection of sepsis in the current sepsis scoring systems.

scholarly journals Predicting mortality in patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review.

2020 ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Multiple Biomarkers ◽  
Clinical Scoring

Abstract Introduction Sepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED.Methods We performed a systematic search using MEDLINE, PubMed, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the diagnostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. Results We found 18 articles in this systematic review. In these 18 articles, a total of 35 combinations of biomarkers and clinical scoring systems were studied of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. Conclusion In this systematic review, the combination of PCT, IL-6, lactate and the SAPS-2 score had the highest AUC on 1-month mortality in patients with sepsis in the ED. The studies we found in this review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis.

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