scholarly journals Correlation of Quick SOFA Score and Procalcitonin with Mortality in the Emergency Department

2020 ◽  
pp. 64-69
Author(s):  
Mandip Singh Bhatia ◽  
Ritu Attri ◽  
Kumar Rajni Kant ◽  
Saurabh C. Sharda
Keyword(s):  
Emergency Department ◽  
Early Diagnosis ◽  
Organ Dysfunction ◽  
Sofa Score ◽  
Host Response ◽  
Death Sentence ◽  
Suspected Infection ◽  
Life Threatening ◽  
Qsofa Score ◽  
Sensitive Marker

Introduction: Sepsis is defined as life-threatening organ dysfunction caused by the dysregulated host response to infection with high mortality. Early diagnosis and treatment can decrease mortality. Methods: We studied 2031 patients presenting to an emergency department with fever or suspected infection to find the correlation between q SOFA SCORE and procalcitonin levels with mortality. Results: It is seen that mortality is directly proportionate to qSofa score and we also found that the value of procalcitonin is directly proportionate to qSofa score. Conclusion: Combination of qSofa score with procalcitonin is a sensitive marker of death in sepsis. qSofa score of 2 or more is associated with increased mortality but its, not death sentence if all such patients treated aggressively & timely then the majority of them would survive.

scholarly journals Recent application of metabolomics in the diagnosis, pathogenesis, treatment, and prognosis of sepsis

2021 ◽  
Keyword(s):  
Early Diagnosis ◽  
Organ Dysfunction ◽  
Host Response ◽  
Clinical Manifestations ◽  
Rapid Diagnosis ◽  
Pathophysiological Mechanism ◽  
Recent Application ◽  
Biochemical Pathways ◽  
Diagnosis And Prognosis ◽  
Life Threatening

Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infections. It is a leading cause of morbidity and mortality in hospitalized patients. Patients with sepsis often require care in the intensive care unit (ICU) which is costly to the patients and their families. Sepsis has no specific clinical manifestations, and its pathophysiological mechanism is complex. The disease progresses rapidly which makes early diagnosis difficult. Severe forms of the disease, such as septic shock, may lead to organ dysfunction, organ failure, and death. As an emerging “-omics” technology, metabolomics has revolutionized the clinical and research landscape of sepsis. Metabolomics has been applied in the prognosis, diagnosis, and risk stratification in patients with sepsis. This technology provides details on the metabolites and biochemical pathways commonly associated with the pathophysiology of sepsis. At present, it is mostly used to identify metabolites in various diseases. Using this technology, metabolites in body fluids such as blood and urine are detected and analyzed in relation to disease progresssion. The technology therefore helps to understand the pathogenesis of diseases and promote early diagnosis and treatment of the disease. So far, the applicaition of metabolomics in patients with sepsis has not been well defined. This article briefly reviews the application of metabolomics technology in patients with sepsis in recent years, to generate ideas for improving rapid diagnosis and prognosis evaluation of patients with sepsis.

scholarly journals CORRELATION BETWEEN PRESEPSIN AND SEQUENTIAL [SEPSIS-RELATED] ORGAN FAILURE ASSESSMENT (SOFA) SCORE AS AN ORGAN DYSFUNCTION MARKER IN SEPSIS

2019 ◽  
Vol 25 (1) ◽  
pp. 47
Author(s):  
Stevi Dwiyani ◽  
Agnes Rengga Indrati ◽  
Leni Lismayanti ◽  
Adhi Kristianto S
Keyword(s):  
Organ Dysfunction ◽  
Sofa Score ◽  
Host Response ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Innate Immune ◽  
Cross Sectional ◽  
Failure Assessment ◽  
Life Threatening ◽  
Cluster Of Differentiation

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The latest consensus in 2016 (Sepsis-3) identified organ dysfunction as an acute change in total SOFA score ≥2 points. An ideal laboratory examination is expected to detect sepsis in an early stage and correlated with the degree of infection. Presepsin or Soluble Cluster of Differentiation 14 Sub Type (sCD14-ST) is a proteolysis product of CD14 that is produced in 1-2 hour after innate immune activation during infections. The aim of this study was to determine the correlation of presepsin and SOFA score as an organ dysfunction marker in sepsis. This research was an observational, analytical cross-sectional study conducted in the Dr. Hasan Sadikin Hospital (RSHS) Bandung from September 2016 until July 2017. The subjects were 42 patients from the Emergency Department diagnosed as sepsis by clinicians using criteria of SOFA score ≥2 points. The serum sample was collected and measured for presepsin concentration. A correlation test was analyzed with Spearman analysis. This study showed the increasing of presepsin concentration associated with SOFA score (p=0.000; r=0.660). There was a positive correlation between presepsin and SOFA score as an organ dysfunction marker

scholarly journals The Role and Mechanism of Pyroptosis and Potential Therapeutic Targets in Sepsis: A Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiangtao Zheng ◽  
Weiwei Chen ◽  
Fangchen Gong ◽  
Ying Chen ◽  
Erzhen Chen
Keyword(s):  
Immune Response ◽  
Organ Dysfunction ◽  
Host Response ◽  
Therapeutic Targets ◽  
Host Immune Response ◽  
Unique Form ◽  
Pathogen Infection ◽  
Programmed Death ◽  
Life Threatening ◽  
Future Direction

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Recently was been found that pyroptosis is a unique form of proinflammatory programmed death, that is different from apoptosis. A growing number of studies have investigated pyroptosis and its relationship with sepsis, including the mechanisms, role, and relevant targets of pyroptosis in sepsis. While moderate pyroptosis in sepsis can control pathogen infection, excessive pyroptosis can lead to a dysregulated host immune response and even organ dysfunction. This review provides an overview of the mechanisms and potential therapeutic targets underlying pyroptosis in sepsis identified in recent decades, looking forward to the future direction of treatment for sepsis.

scholarly journals Assessment of a Cellular Host Response Test as a Sepsis Diagnostic for Those With Suspected Infection in the Emergency Department

2021 ◽  
Vol 3 (6) ◽  
pp. e0460
Author(s):  
Hollis R. O’Neal ◽  
Roya Sheybani ◽  
Terrell S. Caffery ◽  
Mandi W. Musso ◽  
Diana Hamer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Host Response ◽  
Suspected Infection ◽  
Response Test

The Association of Sepsis Syndrome and Organ Dysfunction With Mortality in Emergency Department Patients With Suspected Infection

2006 ◽  
Vol 48 (5) ◽  
pp. 583-590.e1 ◽  
Author(s):  
Nathan Shapiro ◽  
Michael D. Howell ◽  
David W. Bates ◽  
Derek C. Angus ◽  
Long Ngo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Organ Dysfunction ◽  
Sepsis Syndrome ◽  
Suspected Infection ◽  
Emergency Department Patients

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.

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 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 CXCL5-mediated recruitment of neutrophils into the peritoneal cavity ofGdf15-deficient mice protects against abdominal sepsis

2020 ◽  
Vol 117 (22) ◽  
pp. 12281-12287 ◽  
Author(s):  
Isa Santos ◽  
Henrique G. Colaço ◽  
Ana Neves-Costa ◽  
Elsa Seixas ◽  
Tiago R. Velho ◽  
...  
Keyword(s):  
Septic Shock ◽  
Organ Dysfunction ◽  
Peritoneal Cavity ◽  
Host Response ◽  
Abdominal Sepsis ◽  
Neutrophil Recruitment ◽  
Life Threatening ◽  
Pathogen Control ◽  
Circulating Levels ◽  
Deficient Mice

Sepsis is a life-threatening organ dysfunction condition caused by a dysregulated host response to an infection. Here we report that the circulating levels of growth and differentiation factor-15 (GDF15) are strongly increased in septic shock patients and correlate with mortality. In mice, we find that peptidoglycan is a potent ligand that signals through the TLR2-Myd88 axis for the secretion of GDF15, and thatGdf15-deficient mice are protected against abdominal sepsis due to increased chemokine CXC ligand 5 (CXCL5)-mediated recruitment of neutrophils into the peritoneum, leading to better local bacterial control. Our results identify GDF15 as a potential target to improve sepsis treatment. Its inhibition should increase neutrophil recruitment to the site of infection and consequently lead to better pathogen control and clearance.

scholarly journals Role of presepsin for the evaluation of sepsis in the emergency department

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Elisa Pizzolato ◽  
Marco Ulla ◽  
Claudia Galluzzo ◽  
Manuela Lucchiari ◽  
Tilde Manetta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Early Diagnosis ◽  
Bacterial Infections ◽  
Acute Phase Proteins ◽  
Great Sensitivity ◽  
Healthy Population ◽  
Suspected Sepsis ◽  
Gold Standard Method ◽  
Suspected Infection

AbstractSepsis, severe sepsis and septic shock are among the most common conditions handled in the emergency department (ED). According to new Sepsis Guidelines, early diagnosis and treatment are the keys to improve survival. Plasma C-reactive protein (CRP) and procalcitonin (PCT) levels, when associated with documented or suspected infection, are now part of the definitions of sepsis. Blood culture is the gold standard method for detecting microorganisms but it requires too much time for results to be known. Sensitive biomarkers are required for early diagnosis and as indexes of prognosis sepsis. CRP is one of the acute phase proteins synthesized by the liver: it has a great sensitivity but a very poor specificity for bacterial infections. Moreover, the evolution of sepsis does not correlate with CRP plasma changes. In recent years PCT has been widely used for sepsis differential diagnosis, because of its close correlation with infections, but it still retains some limitations and false positivity (such as in multiple trauma and burns). Soluble CD14 subtype (sCD14-ST), also known as presepsin, is a novel and promising biomarker that has been shown to increase significantly in patients with sepsis, in comparison to the healthy population. Studies pointed out the capability of this biomarker for diagnosing sepsis, assessing the severity of the disease and providing a prognostic evaluation of patient outcome. In this mini review we mainly focused on presepsin: we evaluate its diagnostic and prognostic roles in patients presenting to the ED with systemic inflammatory response syndrome (SIRS), suspected sepsis or septic shock.

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