Role of qSOFA and SOFA Scoring Systems for Predicting In-Hospital Risk of Deterioration in the Emergency Department

López-Izquierdo, Raúl; Brio-Ibañez, Pablo Del; Martin-Rodríguez, Francisco; Mohedano-Moriano, Alicia; Polonio-López, Begoña; Maestre-Miquel, Clara; Viñuela, Antonio; Durantez-Fernández, Carlos; Villamor, Miguel Ángel Castro; Conty, José Luis Martín

doi:10.3390/ijerph17228367

Cited by 10 publications

(9 citation statements)

References 38 publications

(59 reference statements)

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“…In this line, two studies by Koch et al 16 and Loonen et al 17 evaluated diagnostic accuracy of suPAR have shown specificity from 64–77%. Also, the current findings agreed with the study by López-Izquierdo et al 18 found that for 28-day mortality, the qSOFA presented a cut-off of two points, with a sensitivity of 74.3 and specificity of 73.1. The SOFA score presented a cut-off of three points for 30-day mortality, with a sensitivity of 81.6 and a specificity of 76.5.…”

Section: Discussionsupporting

confidence: 93%

Thrombo-inflammatory biomarkers to predict sepsis outcome

Efat

Shoeib

Arafa

et al. 2021

Int J Immunopathol Pharmacol

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Background: Sepsis has been redefined recently as life-threatening organ dysfunction caused by dysregulated host responses to infection and septic shock. Soluble urokinase plasminogen activator receptor (SuPAR) and plasminogen activator inhibitor-1(PAI-1) concentration positively correlate to the activation level of the immune system, and are markers of disease severity and aggressiveness. Objective: The study aimed to identify the blood level of plasminogen activator inhibitor-1 (PAI-1) and soluble urokinase plasminogen activator receptor (SuPAR) in sepsis and its association with mortality. Patient and methods: This is an observational prospective study that enrolled 60 adult patients with sepsis (according to SOFA), admitted to Menoufia and Zagazig university hospitals during the period from December 2019 till October 2020. Plasminogen activator inhibitor-1 (PAI-1) and soluble urokinase plasminogen activator receptor (SuPAR) were checked in all participants. Results: SuPAR and PAI.1 were significant independent predictors of hospital mortality. SuPAR showed sensitivity 100%, specificity 95.9%, and accuracy 94% for prediction of early mortality at a cutoff value of 13.4(pg/ml). While, PAI-1 demonstrated sensitivity 100%, specificity 93.9%, and accuracy of 95% at a cutoff value of 122.5 for predicting mortality. Conclusion: PAI-1 and suPAR were significant predictors of hospital mortality among sepsis patients. The sample size was relatively small, which may have decreased the statistical power of the results of the present study. Hence, additional studies with large sample sizes are required for further validation of the present results.

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Section: Discussionsupporting

confidence: 93%

Thrombo-inflammatory biomarkers to predict sepsis outcome

Efat

Shoeib

Arafa

et al. 2021

Int J Immunopathol Pharmacol

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“…AUROC for the SOFA was in our study lower than in prior studies (Table 4). 9,[11][12][13][14]19,[21][22][23][24][25] The different findings can be explained by differences in methodology. Several studies 9,11,12,22,23 have used the worst values of variables from the ED stay to calculate SOFA.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Accuracy of SOFA, qSOFA, and SIRS for Mortality Among Emergency Department Patients with Infections

Abdullah¹,

Sørensen²,

Nielsen³

2021

IDR

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This study aimed to determine the prognostic accuracy of SOFA in comparison to quick-SOFA (qSOFA) and systemic inflammatory response syndrome (SIRS) in predicting 28-day mortality in the emergency department (ED) patients with infections. Methods: A secondary analysis of data from a prospective study of adult patients with documented or suspected infections admitted to an ED in Denmark from Oct-2017 to Mar-2018. The SOFA scores were calculated after adjustment for chronic diseases. The prognostic accuracy was assessed by analysis of sensitivity, specificity, predictive values, likelihood ratios, and area under the receiver operating characteristic curve (AUROC) with 95% confidence intervals (CI). Results: A total of 2045 patients with a median age of 73.2 (IQR: 60.9-82.1) years were included. The overall 28-day mortality was 7.7%. In patients meeting a SOFA score ≥2, qSOFA score ≥2, and SIRS criteria ≥2 the 28-day mortality was 13.6% (11.2-16.3), 17.8% (12.4-24.3) and 8.3% (6.7-10.2), respectively. SOFA ≥2 had a sensitivity of 61.4% (53.3-69.0) and specificity of 67.3% (65.1-69.4), qSOFA ≥2 had a sensitivity of 19.6% (13.7-26.7) and specificity of 92.4% (91.1-93.6), and SIRS ≥2 had a sensitivity of 52.5% (44.4-60.5) and specificity of 51.5% (49.2-53.7). The AUROC for SOFA compared to SIRS was: 0.68 vs 0.52; p<0.001 and compared to qSOFA: 0.68 vs 0.63; p=0.018. Conclusion:A SOFA score of at least two had better prognostic accuracy for 28-day mortality than SIRS and qSOFA. However, the overall accuracy of SOFA was poor for the prediction of 28-day mortality.

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“…Thus, it proves that although respondents do not know the updated definition of sepsis based on the Sepsis-3 guidelines, respondents know the qSOFA indicators as clinical criteria for sepsis. Furthermore, López-Izquierdo et al (2020) also stated in their research that the qSOFA score could be used as an initial assessment to detect patients at high risk of sepsis [34]. Thus, it is expected that knowing the clinical criteria for sepsis based on qSOFA respondents can have good behavior in the early detection of sepsis.…”

Section: Discussionmentioning

confidence: 99%

The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis

Stefani

Trisyani

Setyawati

2021

Open Access Maced J Med Sci

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Background: Sepsis is a life-threatening condition due to the failure of the body’s regulation of infection. Knowledge deficit is one of the barriers to early detection and initiation of sepsis care. Nursing internship program students as future nurses need to have sufficient knowledge about early detection of sepsis to support their behavior. Thus, the purpose of this study was to describe the knowledge of nursing internship program students regarding the early detection of sepsis and the demographic factor related to the knowledge. Methods: The study design was a quantitative study. Through the proportionate stratified non-random sampling technique, the researcher involved 143 nursing internship program students of Universitas Padjadjaran. Data collection used a questionnaire based on the Sepsis-3 guidelines to measure nursing internship program students’ knowledge about early detection of sepsis. The data was carried out in July-August 2021. Results: The average knowledge score of the respondents was 70.4 (SD=11.9). More than half of the respondents (56.6%) got a score below the average. Almost all respondents do not know the current definition of sepsis and still use the SIRS definition as clinical criteria for sepsis. However, respondents could identify clinical criteria for sepsis based on qSOFA and analyse sepsis indicators based on case scenarios. Meanwhile, based on its characteristics, the information is a factor that significantly affects the knowledge score (p < 0.05). Conclusion: In conclusion, there is still a gap in the knowledge of the nursing internship program students regarding the update of the Sepsis-3 guidelines. Besides, information is identified as the factor that influences knowledge. Therefore, it suggested that the institution provide further effective educational methods to update students’ knowledge about the early detection of sepsis.

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Role of qSOFA and SOFA Scoring Systems for Predicting In-Hospital Risk of Deterioration in the Emergency Department

Cited by 10 publications

References 38 publications

Thrombo-inflammatory biomarkers to predict sepsis outcome

Thrombo-inflammatory biomarkers to predict sepsis outcome

Prognostic Accuracy of SOFA, qSOFA, and SIRS for Mortality Among Emergency Department Patients with Infections

The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis

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