Prognostic Value of Severity Score Change for Septic Shock in the Emergency Room

Hwang, Tae Sik; Park, Hyun Woo; Park, Ha Young; Park, Sung Chul

doi:10.3390/diagnostics10100743

Cited by 7 publications

(13 citation statements)

References 18 publications

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“…Early measurements were probably made before any treatment was provided, whereas later measurements were more likely after everything possible had been done, and little more could save the patient. This hypothesis is supported by the report of Hwang et al [34] who found that the AUC of NEWS for 7-day mortality of patients with sepsis was 0.680 when measured at triage, 0.777 after resuscitation with fluid and vasopressors, and 0.888 on exiting the emergency department. Others have also shown the discrimination of NEWS to be lower on arrival to hospital than when repeated later [28,35].…”

Section: General Interpretation Of the Results In The Context Of Othe...supporting

confidence: 68%

A systematic review of the discrimination and absolute mortality predicted by the National Early Warning Scores according to different cut-off values and prediction windows

Holland

Kellett

2022

European Journal of Internal Medicine

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Section: General Interpretation Of the Results In The Context Of Othe...supporting

confidence: 68%

A systematic review of the discrimination and absolute mortality predicted by the National Early Warning Scores according to different cut-off values and prediction windows

Holland

Kellett

2022

European Journal of Internal Medicine

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“…Following title and abstract screening, 26 articles remained, excluding 1595 articles. From this, full texts were retrieved, and 11 studies selected for inclusion 20 21 28–36. A flow chart demonstrating this process can be seen in figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The type of mortality reported varied (table 1). Three studies used 30-day or 28-day mortality as their primary outcome,29 30 36 four studies used in-hospital mortality,20 31 33 35 one study used 7-day mortality32 and one other did not specify (table 2). 34 Of the final two studies, one used a composite of ICU length of stay, vasopressor use and mortality within 72 hours of presentation,28 and the other looked at a composite of adverse outcomes, specified as either a prolonged stay in ICU ≥72 hours or in-hospital mortality 21…”

Section: Resultsmentioning

confidence: 99%

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Does lactate enhance the prognostic accuracy of the quick Sequential Organ Failure Assessment for adult patients with sepsis? A systematic review

et al. 2022

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ObjectivesTo investigate whether adding lactate to the quick Sequential (sepsis-related) Organ Failure Assessment (qSOFA) improves the prediction of mortality in adult hospital patients, compared with qSOFA alone.DesignSystematic review in accordance with Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies guidelines.Data sourcesEmbase, Medline, PubMed, SCOPUS, Web of Science, CINAHL and Open Grey databases were searched in November 2020.Eligibility criteriaOriginal research studies published after 2016 comparing qSOFA in combination with lactate (LqSOFA) with qSOFA alone in adult patients with sepsis in hospital. The language was restricted to English.Data extraction and synthesisTitle and abstract screening, full-text screening, data extraction and quality assessment (using Quality Assessment of Diagnostic Accuracy Studies-2) were conducted independently by two reviewers. Extracted data were collected into tables and diagnostic test accuracy was compared between the two tests.ResultsWe identified 1621 studies, of which 11 met our inclusion criteria. Overall, there was a low risk of bias across all studies. The area under the receiver operating characteristic (AUROC) curve for qSOFA was improved by the addition of lactate in 9 of the 10 studies reporting it. Sensitivity was increased in three of seven studies that reported it. Specificity was increased in four of seven studies that reported it. Of the six studies set exclusively within the emergency department, five published AUROCs, all of which reported an increase following the addition of lactate. Sensitivity and specificity results varied throughout the included studies. Due to insufficient data and heterogeneity of studies, a meta-analysis was not performed.ConclusionsLqSOFA is an effective tool for identifying mortality risk both in adult inpatients with sepsis and those in the emergency department. LqSOFA increases AUROC over qSOFA alone, particularly within the emergency department. However, further original research is required to provide a stronger base of evidence in lactate measurement timing, as well as prospective trials to strengthen evidence and reduce bias.PROSPERO registration numberCRD42020207648.

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“…Setores aplicados NEWS 19 DE APACHE III, MEDS, MEWS, PIRO, REMS, SAPS II, SCS, SOFA, ViEWS 20 Enfermaria eCART, MEWS, NEWS, qSOFA, SIRS, SOFA 21 DE e Enfermaria MEWS, NEWS, qSOFA, SIRS 22 DE e Enfermaria HEWS, NEWS 23 DE NEWS, qSOFA, SIRS 24 DE HEWS, NEWS2 25 Enfermaria MEWS 26 DE NEWS, qSOFA 27 Pré-hospitalar, DE e Enfermaria BTF, MEWS, NEWS, qSOFA, SIRS 28 DE e Enfermaria NEWS, qSOFA, SIRS 29 DE e Ambulatório NEWS, qSOFA, SIRS 30…”

Section: Escores Utilizadosunclassified

Escores de alerta precoce em pacientes com suspeita ou diagnóstico de sepse: uma revisão integrativa [Early warning scores in patients with suspected or diagnosed sepsis: an integrative review] [Puntuaciones de alerta temprana en pacientes con sospecha o diagnóstico de sepsis: una revisión integradora]

et al. 2022

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Objetivo: analisar publicações científicas sobre a utilização de escores de alerta precoce, nos serviços terciários, como ferramentas de detecção da deterioração clínica em paciente com suspeita ou diagnóstico de sepse. Método: revisão integrativa realizada na PubMed, Scopus, Web of Science e Biblioteca Virtual em Saúde entre fevereiro e março de 2021. Incluídos artigos em inglês, espanhol e português, sem delimitação de tempo na busca. Resultados: identificou-se diferentes escores para detecção precoce da deterioração clínica em pacientes com suspeita ou diagnóstico de sepse. As ferramentas mais frequentes nos serviços terciários foram: National Early Warning Score, Sequential Organ Failure Assessment Score e Systemic Inflammatory Response Syndrome (n=6) (50%), sendo a maioria nos Departamentos de Emergências (n=5) (41,6%). Considerações finais: National Early Warning Score foi o escore mais utilizado para pacientes com suspeita ou diagnóstico de sepse com maior acurácia para a predição de mortalidade hospitalar e admissão em Unidade de Terapia Intensiva.ABSTRACTObjective: to examine scientific publications on the use of early warning scores in tertiary services as tools for detecting clinical deterioration in patients with suspected or diagnosed sepsis. Method: this integrative review was conducted in PubMed, Scopus, Web of Science and the Virtual Health Library between February and March 2021. Articles in English, Spanish, and Portuguese were included with no time limits on the search. Results: different scores were found for early detection of clinical deterioration in patients with suspected or diagnosed sepsis. The most frequent tools in tertiary services were the National Early Warning Score, Sequential Organ Failure Assessment Score and Systemic Inflammatory Response Syndrome (n = 6) (50%), most of them in Emergency Departments (n = 5) (41.6 %). Final remarks: the National Early Warning Score was the most used for patients with suspected or diagnosed sepsis and was the most accurate in predicting hospital mortality and admission to the Intensive Care Unit.RESUMENObjetivo: analizar publicaciones científicas sobre la utilización de puntuaciones de alerta temprana, en servicios terciarios, como herramientas para detección de deterioro clínico en pacientes con sospecha o diagnóstico de sepsis. Método: revisión integradora en PubMed, Scopus, Web of Science y Biblioteca Virtual en Salud entre febrero y marzo de 2021. Fueron incluidos artículos en inglés, español y portugués, sin límite de tiempo en la búsqueda. Resultados: se identificaron diferentes puntuaciones para detección temprana de deterioro clínico en pacientes con sospecha o diagnóstico de sepsis. Las herramientas frecuentes en los servicios terciarios fueron: National Early Warning Score, Sequential Organ Failure Assessment Score y Systemic Inflammatory Response Syndrome (n=6) (50%), la mayoría en Servicios de Emergencia (n=5) (41,6 %). Consideraciones finales: National Early Warning Score fue la puntuación más utilizada para pacientes con sospecha o diagnóstico de sepsis con mejor precisión para predecir la mortalidad hospitalaria e ingreso a la Unidad de Cuidados Intensivos.

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Prognostic Value of Severity Score Change for Septic Shock in the Emergency Room

Cited by 7 publications

References 18 publications

A systematic review of the discrimination and absolute mortality predicted by the National Early Warning Scores according to different cut-off values and prediction windows

A systematic review of the discrimination and absolute mortality predicted by the National Early Warning Scores according to different cut-off values and prediction windows

Does lactate enhance the prognostic accuracy of the quick Sequential Organ Failure Assessment for adult patients with sepsis? A systematic review

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