Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward

Kopczynska, Maja; Sharif, Ben; Cleaver, Sian; Spencer, Naomi; Kurani, Amit; C, Lee; Davis, J. Wade; Durie, Carys; Joseph-Gubral, Jude; Sharma, Angelica; Allen, Lucy; Atkins, Billie; Gordon, Alexandra June; Jones, Llewelyn; Noble, Amy; Bradley, Matthew John; Atkinson, Henry; Inns, Joy; Penney, Harriet; Gilbert, Carys; Walford, Rebecca; Pike, Louise; Edwards, Ross; Howcroft, Robyn; Preston, Hazel; Gee, James C.; Doyle, Nicholas A.; Maden, Charlotte; Smith, Claire; Nsn, Azis; Vadivale, Navrhinaa; Battle, Ceri; Lyons, Ronan A; Morgan, P.; Pugh, Richard; Szakmány, Tamás

doi:10.1097/md.0000000000013238

Cited by 24 publications

(31 citation statements)

References 29 publications

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“…A retrospective cohort study including 104 cases showed that the APACHE-II score was a poor predictor of mortality in patients with epileptic status in the ICU and reported an AUC of 0.58 (0.45, 0.72) [26]. The SOFA score which was previously known as the sepsis-related organ failure assessment score [27][28][29], was used to assess failure in organ function. The SOFA score is based on six different aspects related to respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems.…”

Section: Discussionmentioning

confidence: 99%

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SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

et al. 2020

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Background: Acute kidney injury (AKI) is the most common cause of organ failure in multiple organ dysfunction syndrome (MODS) and is associated with increased mortality. This study aimed at determining the efficacy of sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation II (APACHE-II) scoring systems in assessing the prognosis of critically ill patients with AKI undergoing continuous renal replacement therapy (CRRT). At present, APACHE-II score and SOFA score were also used to evaluate and predict the prognosis of critically ill patients with AKI. Methods: The predictive value of SOFA and APACHE-II scores for 28-and 90-d mortality in patients with AKI undergoing CRRT were determined by multivariate analysis, sensitivity analysis, and curve-fitting analysis. Results: A total of 836 cases were included in this study. Multivariate Cox logistic regression analysis showed that SOFA scores were associated with 28-and 90-d mortality in patients with AKI undergoing CRRT.

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Section: Discussionmentioning

confidence: 99%

“…Multivariate logistic regression analysis revealed that only SOFA score was associated with 28-and 90-d mortality in patients with AKI undergoing CRRT. However, the APACHE II score was not associated with 28 (Table 3).…”

Section: Multivariate Cox Regression Analysismentioning

confidence: 98%

SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

et al. 2020

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“…In this scenario, frailty and multimorbidity may play a relevant role in defining the prognostic trajectory, even when an acute, disseminated, and life-threatening infection is present. Interestingly, in a nation-wide point-prevalence sepsis study conducted in Wales, Kopzynska et al [47] found that frailty, measured with the RCFS, was a significant predictor of mortality, unlike qSOFA or SIRS.…”

Section: Discussionmentioning

confidence: 99%

Application of The Sepsis-3 Consensus Criteria in a Geriatric Acute Care Unit: A Prospective Study

Bastoni

Ticinesi

Lauretani

et al. 2019

JCM

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The prognostic value of quick Sepsis-related Organ Failure Assessment (qSOFA) score in geriatric patients is uncertain. We aimed to compare qSOFA vs. Systemic Inflammatory Response Syndrome (SIRS) criteria for mortality prediction in older multimorbid subjects, admitted for suspected sepsis in a geriatric ward. We prospectively enrolled 272 patients (aged 83.7 ± 7.4). At admission, qSOFA and SIRS scores were calculated. Mortality was assessed during hospital stay and three months after discharge. The predictive capacity of qSOFA and SIRS was assessed by calculating the Area Under the Receiver Operating Characteristic Curve (AUROC), through pairwise AUROC comparison, and multivariable logistic regression analysis. Both qSOFA and SIRS exhibited a poor prognostic performance (AUROCs 0.676, 95% CI 0.609–0.738, and 0.626, 95% CI 0.558–0.691 for in-hospital mortality; 0.684, 95% CI 0.614–0.748, and 0.596, 95% CI 0.558–0.691 for pooled three-month mortality, respectively). The predictive capacity of qSOFA showed no difference to that of SIRS for in-hospital mortality (difference between AUROCs 0.05, 95% CI −0.05 to 0.14, p = 0.31), but was superior for pooled three-month mortality (difference between AUROCs 0.09, 95% CI 0.01–0.17, p = 0.029). Multivariable logistic regression analysis, accounting for possible confounders, including frailty, showed that both scores were not associated with in-hospital mortality, although qSOFA, unlike SIRS, was associated with pooled three-month mortality. In conclusion, neither qSOFA nor SIRS at admission were strong predictors of mortality in a geriatric acute-care setting. Traditional geriatric measures of frailty may be more useful for predicting adverse outcomes in this setting.

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“…Patients with suspected sepsis or septic shock included in the study were retrospectively evaluated by SIRS criteria of 1991, Second Consensus Conference Criteria of 2001, the modified Second Consensus Conference Criteria of 2001 (obtaining SIRS Criteria and SOFA score), Third Consensus Conference Criteria of 2016, in addition to the dosage of PCT and MR-proADM [3][4][5][6] . A SOFA or a qSOFA scores ≥ 2 from baseline has been considered diagnostic of sepsis.…”

Section: Sepsis Diagnosismentioning

confidence: 99%

“…Since 2001, the Second Consensus Conference of Sepsis recommended adding the use of biomarkers to SIRS criteria to overcome these limits 4 , 5 , 11 . During infection, indeed, PCT has the ability to discriminate between infectious and not-infectious SIRS, and to guide antimicrobial therapy and follow-up 12 – 15 .…”

Section: Introductionmentioning

confidence: 99%

Best diagnostic accuracy of sepsis combining SIRS criteria or qSOFA score with Procalcitonin and Mid-Regional pro-Adrenomedullin outside ICU

Spoto

Nobile

Carnà

et al. 2020

Sci Rep

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Early diagnosis and treatment significantly reduce sepsis mortality. Currently, no gold standard has been yet established to diagnose sepsis outside the ICU. The aim of the study was to evaluate the diagnostic accuracy of sepsis defined by SIRS Criteria of 1991, Second Consensus Conference Criteria of 2001, modified Second Consensus Conference Criteria of 2001 (obtaining SIRS Criteria and SOFA score), Third Consensus Conference of 2016, in addition to the dosage of Procalcitonin (PCT) and MR-pro-Adrenomedullin (MR-proADM). In this prospective study, 209 consecutive patients with clinical diagnosis of sepsis were enrolled (May 2014–June 2018) outside intensive care unit (ICU) setting. A diagnostic protocol could include SIRS criteria or qSOFA score evaluation, rapid testing of PCT and MR-proADM, and SOFA score calculation for organ failure definition. Using this approach outside the ICU, a rapid diagnostic and prognostic evaluation could be achieved, also in the case of negative SIRS, qSOFA or SOFA scores with high post-test probability to reduce mortality and improve outcomes.

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Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward

Abstract: Supplemental Digital Content is available in the text

Cited by 24 publications

References 29 publications

SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

Application of The Sepsis-3 Consensus Criteria in a Geriatric Acute Care Unit: A Prospective Study

Best diagnostic accuracy of sepsis combining SIRS criteria or qSOFA score with Procalcitonin and Mid-Regional pro-Adrenomedullin outside ICU

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