Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department

Autor: Ali Fuat Oduncu, Güçlü Selahattin Kiyan, Sercan Yalçınlı
Rok vydání: 2021
Předmět:
Male
Organ Dysfunction Scores
Care
Severity of Illness Index
0302 clinical medicine
qSOFA
Medicine
SIRS
Prospective Studies
Prospective cohort study
Prognostic Accuracy
Aged
80 and over
Mortality rate
General Medicine
NEWS
Middle Aged
Early warning score
Prognosis
Predictive value
Systemic Inflammatory Response Syndrome
Organ Failure
Predicting Mortality
Emergency Medicine
Female
Sofa Scores
Infection
Emergency Service
Hospital
Adult
medicine.medical_specialty
Adolescent
In-Hospital Mortality
International Consensus Definitions
Sensitivity and Specificity
Sepsis
03 medical and health sciences
Young Adult
Internal medicine
Humans
Mortality
Aged
business.industry
Septic shock
030208 emergency & critical care medicine
Emergency room
Emergency department
medicine.disease
Criteria
Systemic inflammatory response syndrome
Septic Shock
business
Follow-Up Studies
Zdroj: The American journal of emergency medicine. 48
ISSN: 1532-8171
Popis: Purpose: This study was aimed to compare the quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS), and National Early Warning Score (NEWS) scoring systems for diagnosing sepsis and predicting mortality and morbidity. Patients and methods: A prospective study was designed. qSOFA, SIRS, and NEWS scores were calculated at the admission. The diagnosis of sepsis was made with SOFA scoring initially. The morbidity and mortality of the patients were identified during follow-up. Also, the sensitivity, specificity, negative predictive value, and positive predictive value of three scoring systems were calculated. The scoring systems were compared with ROC analysis. Results: A total of 463 patients were evaluated. There were 287 (62.0%) patients diagnosed with sepsis, and septic shock occurred in 64 (13.8%) of patients. Seven-day mortality rate was 8.4% (n = 39), 30-day mortality rate was 18.1% (n = 84). The sensitivity for qSOFA, SIRS, and NEWS for diagnosis of sepsis was 23%, 77%, 58%, and specificity was 99%, 35%, 81% respectively. The sensitivity of the qSOFA, SIRS and NEWS scoring systems for mortality was 39%, 82%, 77% and specificity 91%, 29%, and 64%, respectively. AUROC values for mortality detected as NEWS = 0.772, qSOFA = 0.758, SIRS = 0.542. According to the ROC analysis, the SIRS system was significantly less useful than the qSOFA and NEWS system in the diagnosis of sepsis and mortality (p < 0.0001). Conclusion: NEWS and qSOFA scoring systems have similar prognosis in both diagnosing sepsis and predicting mortality and both are superior to SIRS. (c) 2021 Elsevier Inc. All rights reserved.
Databáze: OpenAIRE
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