qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis

@article{Goulden2018qSOFASA,
  title={qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis},
  author={R. Goulden and M. Hoyle and Jessie Monis and Darran Railton and Victoria Riley and Paul L. Martin and R. Martina and E. Nsutebu},
  journal={Emergency Medicine Journal},
  year={2018},
  volume={35},
  pages={345 - 349}
}
Background The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely… Expand
Comparative prognostic accuracy of sepsis scores for hospital mortality in adults with suspected infection in non-ICU and ICU at an academic public hospital
TLDR
Multivariate prediction scores, such as SOFA and NEWS, had greater prognostic accuracy than qSOFA or SIRS for hospital mortality, ICU transfer, and ICU length of stay and complex sepsis scores may offer enhanced prognostic performance as compared to simple sepsi scores in inpatient hospital settings where more complex scores can be readily calculated. Expand
Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score
TLDR
News is more accurate in predicting 10- and 30-day mortality than qSOFA and SIRS in patients presenting to the ED with suspected sepsis in patients with suspected infection directly at presentation to theED. Expand
Emergency Severity Index as a predictor of in-hospital mortality in suspected sepsis patients in the emergency department.
TLDR
The ESI was accurate and had the highest sensitivity for predicting in-hospital mortality and ICU admission in suspected sepsis patients in the ED, confirming that the ESI is useful in both ED triage and predicting adverse outcomes in these patients. Expand
NEWS2 Is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department
TLDR
News2 was superior to qSOFA for screening for sepsis with organ dysfunction, infection-related mortality or intensive care due to an infection both among infected patients and among undifferentiated patients at emergency departments. Expand
Prognostic accuracy of qSOFA in predicting 28-day mortality among infected patients in an emergency department: a prospective validation study
TLDR
Both SIRS and qSOFA had poor sensitivity for 28-day mortality andqSOFA improved the specificity at the expense of the sensitivity resulting in slightly higher prognostic accuracy overall. Expand
The utility of the rapid emergency medicine score (REMS) compared with SIRS, qSOFA and NEWS for Predicting in-hospital Mortality among Patients with suspicion of Sepsis in an emergency department
TLDR
REMS was an early warning score with higher accuracy than sepsis-related scores (qSOFA and SirS), similar to NEWS, and had the highest utility in terms of net benefit compared to SIRS, qSOFA, and NEWS in predicting in-hospital mortality in patients presenting to the ED with suspected sepsi. Expand
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection
TLDR
To predict in-hospital mortality in patients visiting to the emergency department with suspected infection, qSOFA was demonstrated to be modestly more accurate than the SIRS criteria albeit insufficiently sensitive. Expand
National Early Warning Score (NEWS) as Prognostic Triage Tool for Septic Patients
TLDR
The NEWS was a sensitive screening tool for predicting sepsis-related outcomes, however, it was not specific, and further studies are recommended to assess the integration of other factors to improve specificity. Expand
NEWS and qSIRS superior to qSOFA in the prediction of 30-day mortality in emergency department patients in Hong Kong
TLDR
Among unselected emergency and urgent ED patients, the prognostic value for NEWS and qSIRS were greater than qSOFA, and Combinations of qSOfa and SIRS could improve the predictive value for 30-day mortality for ED patients. Expand
Clinical Scores and Formal Triage for Screening of Sepsis and Adverse Outcomes on Arrival in an Emergency Department All-Comer Cohort.
TLDR
qSOFA offered high specificity for the prediction of sepsis and adverse outcomes, however, its low sensitivity does not support widespread use as a screening tool for sepsi. Expand
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TLDR
In patients with suspected infection who eventually required admission to the ICU, qSOFA calculated before their ICU admission had greater accuracy than SIRS for predicting mortality and ICU-free days, however, it may be less clear whetherqSOFA is also better than S IRS criteria for predicting ventilator free-days and organ dysfunction- free days. Expand
Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality – a prospective study of patients admitted with infection to the emergency department
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Information is added on the RETTS triage system, the two highest acuity levels together had a high sensitivity for identifying sepsis at arrival to the ED - and thus, RETTS should not be replaced by qSOFA as a screening and trigger tool for sepsi at arrival. Expand
Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department
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Among patients presenting to the emergency department with suspected infection, the use of qSOFA resulted in greater prognostic accuracy for in-hospital mortality than did either SIRS or severe sepsis, and these findings provide support for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) criteria in theEmergency department setting. Expand
Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection
Study objective The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identifyExpand
Low Accuracy of Positive qSOFA Criteria for Predicting 28‐Day Mortality in Critically Ill Septic Patients During the Early Period After Emergency Department Presentation
TLDR
The diagnostic performance of positive qSOFA score for predicting 28‐day mortality was low in critically ill septic patients, particularly during the early period after emergency department (ED) presentation. Expand
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Commonly used early warning scores are more accurate than the qSOFA score for predicting death and ICU transfer in non‐ICU patients, and these results suggest that the qsoFA score should not replace general earlywarning scores when risk‐stratifying patients with suspected infection. Expand
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TLDR
The PIRO model, taking into account comorbidities and septic source as well as physiologic status, performed better than the SOFA score and similarly to the MEDS score for predicting mortality in ED patients with severe sepsis and septic shock. Expand
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The findings suggest that screening ward patients using SIRS criteria for identifying those with sepsis would be impractical, and almost half of patients hospitalized on the wards developed SirS at least once during their ward stay. Expand
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An increased NEWS on arrival at ED is associated with higher odds of adverse outcome among patients with sepsis, and the use of NEWS could facilitate patient pathways to ensure triage to a high acuity area of the ED and senior clinician involvement at an early stage. Expand
The prognostic performance of the predisposition, infection, response and organ failure (PIRO) classification in high-risk and low-risk emergency department sepsis populations: comparison with clinical judgement and sepsis category
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The accuracy and discriminative performance of the PIRO score and clinical judgement are similar, but better than the sepsis category, while in high-risk populations a risk stratification tool would be most useful. Expand
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