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Shigeki Kushimoto, Satoshi Gando, Hiroshi Ogura, Yutaka Umemura, Daizoh Saitoh, Toshihiko Mayumi, Seitaro Fujishima, Toshikazu Abe, Atsushi Shiraishi, Hiroto Ikeda, Joji Kotani, Yasuo Miki, Shin-Ichiro Shiraishi, Koichiro Suzuki, Yasushi Suzuki, Naoshi Takeyama, Kiyotsugu Takuma, Ryosuke Tsuruta, Yoshihiro Yamaguchi, Norio Yamashita, Naoki Aikawa
BACKGROUND: Although the quick Sequential Organ Failure Assessment (qSOFA) has been recommended for identifying patients at higher risk of hospital death, it has only a 60% sensitivity for in-hospital mortality. On the other hand, hypothermia associates with increased mortality and organ failure in patients with sepsis. This study aimed to assess the predictive validity of qSOFA for identifying patients with sepsis at higher risk of multiple organ dysfunction or death and the complementary effect of hypothermia...
January 1, 2018: Journal of Intensive Care Medicine
Hyeongkyu Kwak, Gil Joon Suh, Taegyun Kim, Woon Yong Kwon, Kyung Su Kim, Yoon Sun Jung, Jung-In Ko, So Mi Shin
OBJECTIVE: We conducted this study to investigate whether ESI combined with qSOFA score (ESI+qSOFA) predicts hospital outcome better than ESI alone in the emergency department (ED). METHODS: This was a retrospective study for patients aged over 15years who visited an ED of a tertiary referral hospital from January 1st, 2015 to December 31st, 2015. We calculated and compared predictive performances of ESI alone and ESI+qSOFA for prespecified outcomes. The primary outcome was hospital mortality, and the secondary outcome was composite outcome of in-hospital mortality and ICU admission...
January 31, 2018: American Journal of Emergency Medicine
Robert Goulden, Marie-Claire Hoyle, Jessie Monis, Darran Railton, Victoria Riley, Paul Martin, Reynaldo Martina, Emmanuel Nsutebu
BACKGROUND: The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely used National Early Warning Score (NEWS)...
February 21, 2018: Emergency Medicine Journal: EMJ
Sheng Si, Yan Yan, Brian M Fuller, Stephen Y Liang
CONTEXT/OBJECTIVE: Patients with chronic SCI hospitalized for UTI can have significant morbidity. It is unclear whether SIRS criteria, SOFA score, or quick SOFA score can be used to predict complicated outcome. DESIGN: Retrospective cohort study. A risk prediction model was developed and internally validated using bootstrapping methodology. SETTING: Urban, academic hospital in St. Louis, Missouri. PARTICIPANTS: 402 hospitalizations for UTI between October 1, 2010 and September 30, 2015, arising from 164 patients with chronic SCI, were included in the final analysis...
February 21, 2018: Journal of Spinal Cord Medicine
Kyohei Miyamoto, Naoaki Shibata, Tsuyoshi Nakashima, Seiya Kato
OBJECTIVE: This study aimed to evaluate the predictive ability of quick sequential organ failure assessment (qSOFA) score for in-hospital mortality among patients transported by physician-staffed helicopters. METHODS: We conducted a single-center, retrospective observational study using the physician-staffed helicopter registry data between 2003 and 2016. We calculated the qSOFA scores based on the patients' vital signs, which were measured on the scene. The tool's discriminatory ability was determined using the area under the curve of the receiver operating characteristic...
February 10, 2018: American Journal of Emergency Medicine
Lena M Napolitano
BACKGROUND: Sepsis is a global healthcare issue and continues to be the leading cause of death from infection. Early recognition and diagnosis of sepsis is required to prevent the transition into septic shock, which is associated with a mortality rate of 40% or more. DISCUSSION: New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis...
February 2018: Surgical Infections
Paul Barbara, Christopher Graziano, William Caputo, Ilya Litvak, Dominick Battinelli, Barry Hahn
BACKGROUND: Recently a multispecialty, multinational task force convened to redefine the criteria for organ dysfunction, sepsis, severe sepsis, and septic shock. The study recommended the quick sequential organ failure assessment (qSOFA) score to identify sepsis patients. The qSOFA is felt to be the initial screen to prompt a more in-depth sepsis workup. This may be particularly true in resource-limited environments such as the prehospital arena. OBJECTIVES: The goal of this study was to identify whether emergency medical services (EMS) patients who met all three qSOFA criteria correlated with an emergency department (ED) identification of sepsis...
January 31, 2018: American Journal of Emergency Medicine
Ramon T Costa, Antonio P Nassar, Pedro Caruso
PURPOSE: To compare the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) with systemic inflammatory response syndrome (SIRS) criteria in critically ill cancer patients with suspected infection. METHODS: Data for 450 cancer patients admitted to an intensive care unit (ICU) in 2014 with a suspected infection were retrospectively analyzed. Sensitivity, specificity, and area under the receiver operating curve (AUC) values for SOFA, qSOFA, and SIRS criteria for ICU and hospital mortalities were calculated...
January 4, 2018: Journal of Critical Care
Jae-Uk Song, Cheol Kyung Sin, Hye Kyeong Park, Sung Ryul Shim, Jonghoo Lee
BACKGROUND: The usefulness of the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score in providing bedside criteria for early prediction of poor outcomes in patients with suspected infection remains controversial. We investigated the prognostic performance of a positive qSOFA score outside the intensive care unit (ICU) compared with positive systemic inflammatory response syndrome (SIRS) criteria. METHODS: A systematic literature search was performed using MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials...
February 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
Shannon M Fernando, Alexandre Tran, Monica Taljaard, Wei Cheng, Bram Rochwerg, Andrew J E Seely, Jeffrey J Perry
Background: The quick Sequential Organ Failure Assessment (qSOFA) has been proposed for prediction of mortality in patients with suspected infection. Purpose: To summarize and compare the prognostic accuracy of qSOFA and the systemic inflammatory response syndrome (SIRS) criteria for prediction of mortality in adult patients with suspected infection. Data Sources: Four databases from inception through November 2017. Study Selection: English-language studies using qSOFA for prediction of mortality (in-hospital, 28-day, or 30-day) in adult patients with suspected infection in the intensive care unit (ICU), emergency department (ED), or hospital wards...
February 6, 2018: Annals of Internal Medicine
Mervyn Singer, Manu Shankar-Hari
No abstract text is available yet for this article.
February 6, 2018: Annals of Internal Medicine
Karolina Akinosoglou, Spyridoula Theodoraki, Theologia Gkavogianni, Aikaterini Pistiki, Evangelos Giamarellos-Bourboulis, Charalambos A Gogos
Need for prompt recognition and management of sepsis recently led to the introduction of qSOFA score. However, its association with underlying host inflammatory response remains unclear, while previous studies have challenged its performance in non - intensive care unit (ICU) patients comparing to previously used systemic inflammatory response syndrome (SIRS) criteria. Between June 2016 and April 2017, we performed a prospective observational study in the medical ward of a tertiary hospital to explore the relation of qSOFA ≥ 2 and <2 to underlying inflammatory response, as this is mirrored in levels of serum pro- and anti-inflammatory mediators i...
January 27, 2018: Cytokine
Justin J Choi, Matthew W McCarthy
Acute dyspnea is a common chief complaint among patients who visit an emergency room and presents diagnostic challenges for clinicians in both identifying the etiology and determining the clinical severity. The study of biomarkers in the prognostication and risk stratification of these patients has been increasing, including the investigation of the prognostic value for mid-regional pro-adrenomedullin (MR-proADM). Areas Covered: In this review, the authors cover what is known about MR-proADM testing in patients presenting with acute dyspnea and the supporting evidence of its prognostic value in common conditions in medical patients with acute dyspnea, including acute heart failure, community acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and acute pulmonary embolism...
January 10, 2018: Expert Review of Molecular Diagnostics
Hiroshi Fukushima, Masaki Kobayashi, Keizo Kawano, Shinji Morimoto
PURPOSE: The Sepsis-3 Task Force proposed a new definition of sepsis based on SOFA and introduced a novel scoring system, qSOFA, for screening high-risk patients for sepsis. Their clinical usefulness, however, is unclear. Therefore, we investigated their predictive performance for mortality in APN-UTC patients. MATERIALS AND METHODS: This retrospective study included 141 consecutive patients clinically diagnosed with APN-UTC outside the ICU. We evaluated the performance of qSOFA, SOFA, and SIRS in predicting in-hospital mortality and ICU admission using the AUC of the ROC curve, NRI, IDI, and decision curve analysis...
December 29, 2017: Journal of Urology
Rodrigo Serafim, José Andrade Gomes, Jorge Salluh, Pedro Póvoa
BACKGROUND: Several studies were published to validate the quick Sepsis-related Organ Failure Assessment (qSOFA), namely in comparison with the systemic inflammatory response syndrome (SIRS) criteria. We performed a systematic review and meta-analysis with the aim of comparing the qSOFA and SIRS in patients outside the ICU. METHODS: We searched MEDLINE, CINAHL, and the Web of Science database from February 23, 2016 until June 30, 2017 to identify full-text English-language studies published after the Sepsis-3 publication comparing the qSOFA and SIRS and their sensitivity or specificity in diagnosing sepsis, as well as hospital and ICU length of stay and hospital mortality...
December 28, 2017: Chest
Agustín Julián-Jiménez, María Cecilia Yañez, Juan González-Del Castillo, Manuel Salido-Mota, Begoña Mora-Ordoñez, María Jesús Arranz-Nieto, Manuel R Chanovas-Borras, Ferrán Llopis-Roca, Josep María Mòdol-Deltell, Gema Muñoz
OBJECTIVES: To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate, suPAR and pro-adremomedullin) in elderly patients seen in Emergency Departments (ED) due to infections. Secondly, if these could improve the prognostic accuracy of sepsis criteria (systemic inflammatory response syndrome and quick Sepsis-related Organ Failure Assessment [qSOFA]). METHODS: A prospective, observational, multicentre and analytical study...
December 27, 2017: Enfermedades Infecciosas y Microbiología Clínica
Nobuhiro Asai, Hiroki Watanabe, Arufumi Shiota, Hideo Kato, Daisuke Sakanashi, Mao Hagihara, Yusuke Koizumi, Yuka Yamagishi, Hiroyuki Suematsu, Hiroshige Mikamo
The Japanese Respiratory Society newly updated the prognostic guidelines for pneumonia in 2017. Quick Sequential Organ Failure Assessment (qSOFA) and Sequential Organ Failure Assessment (SOFA) score are used to evaluate the severity of pneumonia and to select the therapy for pneumonia. This is a retrospective study at Aichi Medical University hospital from January to December of 2016 to investigate the accuracy and usefulness of qSOFA and SOFA score in evaluating the severity and prognosis of healthcare-associated pneumonia (HCAP)...
December 16, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Ebru Biyikli, Afsin Emre Kayipmaz, Cemil Kavalci
BACKGROUND: Sepsis is a potentially fatal condition with high treatment costs, and is especially common among the elderly population. The emergency management of septic patients has gained importance. OBJECTIVE: Herein, we investigated the effect of admission lactate levels and the platelet-lymphocyte ratio (PLR) on the 30-day mortality among patients older than 65years who were diagnosed with sepsis and septic shock according to the qSOFA criteria at our hospital's emergency department...
December 6, 2017: American Journal of Emergency Medicine
Amith Shetty, Stephen Pj MacDonald, Julian M Williams, John van Bockxmeer, Bas de Groot, Laura M Esteve Cuevas, Annemieke Ansems, Malcolm Green, Kelly Thompson, Harvey Lander, Jaimi Greenslade, Simon Finfer, Jonathan Iredell
OBJECTIVE: The Sepsis-3 task force recommends the use of the quick Sequential Organ Failure Assessment (qSOFA) score to identify risk for adverse outcomes in patients presenting with suspected infection. Lactate has been shown to predict adverse outcomes in patients with suspected infection. The aim of the study is to investigate the utility of a post hoc lactate threshold (≥2 mmol/L) added qSOFA score (LqSOFA(2) score) to predict primary composite adverse outcomes (mortality and/or ICU stay ≥72 h) in patients presenting to ED with suspected sepsis...
December 2017: Emergency Medicine Australasia: EMA
Faheem W Guirgis, Michael A Puskarich, Carmen Smotherman, Sarah A Sterling, Shiva Gautam, Frederick A Moore, Alan E Jones
OBJECTIVES: Sepsis-3 recommends using the quick Sequential Organ Failure Assessment (qSOFA) score followed by SOFA score for sepsis evaluation. The SOFA is complex and unfamiliar to most emergency physicians, while qSOFA is insensitive for sepsis screening and may result in missed cases of sepsis. The objective of this study was to devise an easy-to-use simple SOFA score for use in the emergency department (ED). METHODS: Retrospective study of ED patients with sepsis with in-hospital mortality as the primary outcome...
January 1, 2017: Journal of Intensive Care Medicine
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