Validation of the new Sepsis-3 definitions: proposal for improvement in early risk identification

Abstract

Our analysis positively validated the use of SOFA score to predict unfavourable outcome and to limit misclassification into lower severity. However, qSOFA score had inadequate sensitivity for early risk assessment.

Bacteremia complicating urinary tract infection by Pseudomonas aeruginosa: Mortality risk factors

“…Sepsis‐3 comparatively focuses on organ failure and, importantly, SOFA scores in an ICU or qSOFA outside ICU, which are an index of the patient's general condition, consisting of consciousness, GCS, systolic blood pressure or respiratory frequency . However, some researchers have questioned whether the sepsis‐3 concept is entirely suitable for the urological field and bacteremic UTI, because some patients do not need to be taken care in ICU, so the previous definition and the SIRS or severe sepsis might accurately explain the clinical condition of bacteremic UTI . Therefore, we selected sepsis‐1 and SIRS for evaluation in the present study (see study limitations below).…”

“…13 However, some researchers have questioned whether the sepsis-3 concept is entirely suitable for the urological field and bacteremic UTI, because some patients do not need to be taken care in ICU, so the previous definition and the SIRS or severe sepsis might accurately explain the clinical condition of bacteremic UTI. 14,15 Therefore, we selected sepsis-1 and SIRS for evaluation in the present study (see study limitations below).…”

Getting a consensus: advantages and disadvantages of Sepsis 3 in the context of middle-income settings

“…Initial studies are now showing that qSOFA may have a low sensitivity which is not desirable, but a high specificity to identify patients in a high risk of death, which can just give an alert to approach the patient fastly if this has not yet been done. (7,14,15) In quality improvement programs, our goal is not to identify patients at very high risk of death but rather to identify patients at high risk of deterioration. The usefulness of this score still needs to be determined.…”

SIRS, qSOFA and new sepsis definition

“…qSOFA was specific but poorly sensitive for organ dysfunction (96.1%, 29.7% respectively). Another study in Greece where 3346 infections outside the ICU and 1,058 infections in the ICU were analyzed, qSOFA score provided inadequate sensitivity for early risk assessment (12). This clearly shows that use of qSOFA score risks missing early identification of sepsis when treatment is most effective.…”