Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study.
| Autor: | Melero-Guijarro L; Emergency Department, Complejo Asistencial Universitario de Palencia, Palencia, Spain., Sanz-García A; Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, Spain.; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain., Martín-Rodríguez F; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain.; Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain.; Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain., Lipari V; Universidad Europea del Atlántico, Santader, Spain.; Universidad Internacional Iberoamericana, Campeche, Mexico., Mazas Perez Oleaga C; Universidad Europea del Atlántico, Santader, Spain.; Universidad Internacional Iberoamericana, Arecibo, PR, United States.; Universidade Internacional do Cuanza, Cuito, Bié, Angola., Carvajal Altamiranda S; Universidad Europea del Atlántico, Santader, Spain.; Universidade Internacional do Cuanza, Cuito, Bié, Angola.; Fundación Universitaria Internacional de Colombia, Bogotá, Colombia., Martínez López NM; Universidad Europea del Atlántico, Santader, Spain.; Universidad Internacional Iberoamericana, Campeche, Mexico.; Fundación Universitaria Internacional de Colombia, Bogotá, Colombia., Domínguez Azpíroz I; Universidad Europea del Atlántico, Santader, Spain.; Universidad Internacional Iberoamericana, Campeche, Mexico.; Universidad de La Romana, La Romana, Dominican Republic., Castro Villamor MA; Emergency Department, Complejo Asistencial Universitario de Palencia, Palencia, Spain.; Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, Spain.; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain., Sánchez Soberón I; Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain., López-Izquierdo R; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain.; Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain.; Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in medicine [Front Med (Lausanne)] 2023 Apr 18; Vol. 10, pp. 1149736. Date of Electronic Publication: 2023 Apr 18 (Print Publication: 2023). |
| DOI: | 10.3389/fmed.2023.1149736 |
| Abstrakt: | Background: Nowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality. Methods: Prospective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients ( n = 535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used. Results: The mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841-0.913), 0.761 (95%CI 0.706-0.816), 0.731 (95%CI 0.674-0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA's AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results. Conclusion: The use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Melero-Guijarro, Sanz-García, Martín-Rodríguez, Lipari, Mazas Perez Oleaga, Carvajal Altamiranda, Martínez López, Domínguez Azpíroz, Castro Villamor, Sánchez Soberón and López-Izquierdo.) |
| Databáze: | MEDLINE |
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