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Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua
PURPOSE: We aim to determine whether the combination of regional tissue oxygen saturation (StO2 ) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. METHODS: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4...
February 27, 2018: American Journal of Emergency Medicine
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
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
Pjj Herrod, M Cox, H Keevil, Kje Smith, J N Lund
Background and aims Late recognition of sepsis and consequent death remains a problem. To address this, the National Institute for Health and Care Excellence has published updated guidance recommending the use of the Quick Sequential Organ Failure Assessment (Q-SOFA) score when assessing patients at risk of sepsis following the publication of the Third International Consensus Definitions for Sepsis and Septic Shock. The trauma from major surgery produces a systemic inflammatory response syndrome (SIRS) postoperatively as part of its natural history, which may falsely trigger scoring systems...
January 24, 2018: Annals of the Royal College of Surgeons of England
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
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
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
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
Bodin Khwannimit, Rungsun Bhurayanontachai, Veerapong Vattanavanit
INTRODUCTION: The Sepsis-3 definition provides a change of two or more scores from zero or a known baseline of the Sequential Organ Failure Assessment (SOFA) as criteria of sepsis. The aim of this study was to compare the SOFA score and the quick SOFA (qSOFA) to Systemic Inflammatory Response Syndrome (SIRS) criteria in predictive ability of mortality and organ failure. METHODS: A-10year retrospective cohort study was conducted in a teaching hospital in Thailand...
October 18, 2017: Journal of Critical Care
Selin Tusgul, Pierre-Nicolas Carron, Bertrand Yersin, Thierry Calandra, Fabrice Dami
BACKGROUND: Sepsis is defined as life-threatening organ dysfunction caused by a host response to infection. The quick SOFA (qSOFA) score has been recently proposed as a new bedside clinical score to identify patients with suspected infection at risk of complication (intensive care unit (ICU) admission, in-hospital mortality). The aim of this study was to measure the sensitivity of the qSOFA score, SIRS criteria and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the emergency department (ED) triage...
November 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Husayn A Ladhani, Nitin Sajankila, Brenda M Zosa, Jack C He, Charles J Yowler, Christopher Brandt, Jeffrey A Claridge, Anjay K Khandelwal
BACKGROUND: We evaluated whether qSOFA ≥2 and an increase in SOFA (ΔSOFA) ≥2 can help predict bacteremia in a critically ill burn population. METHODS: Patients age ≥15 and TBSA ≥15% admitted between 2009 and 2015 were included. All blood cultures were recorded, and positive and negative blood culture days were defined based on the culture results. SOFA and qSOFA scores were compared between positive and negative blood culture days. RESULTS: There were 50 patients in our study with a mean age of 47yrs and mean TBSA burn of 37%...
October 21, 2017: American Journal of Surgery
Salvatore Piano, Michele Bartoletti, Marta Tonon, Maurizio Baldassarre, Giada Chies, Antonietta Romano, Pierluigi Viale, Elia Vettore, Marco Domenicali, Marialuisa Stanco, Chiara Pilutti, Anna Chiara Frigo, Alessandra Brocca, Mauro Bernardi, Paolo Caraceni, Paolo Angeli
INTRODUCTION: Patients with cirrhosis have a high risk of sepsis, which confers a poor prognosis. The systemic inflammatory response syndrome (SIRS) criteria have several limitations in cirrhosis. Recently, new criteria for sepsis (Sepsis-3) have been suggested in the general population (increase of Sequential Organ Failure Assessment (SOFA) ≥2 points from baseline). Outside the intensive care unit (ICU), the quick SOFA (qSOFA (at least two among alteration in mental status, systolic blood pressure ≤100 mm Hg or respiratory rate ≥22/min)) was suggested to screen for sepsis...
August 31, 2017: Gut
Ying Wang, Difen Wang, Jiangquan Fu, Ying Liu
OBJECTIVE: Assess the value of several biomarkers and disease severity scores for the prognostic assessment of sepsis. METHODS: The clinical data of adult patients, who met the diagnostic criteria for Sepsis-3 and admitted to the intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University from January 2015 to December 2016 were retrospectively analyzed. These patients were divided into survival group and death group. The levels of serum lactate (Lac), lactate clearance rate of 24 hours later (24 h LCR), procalcitonin (PCT), quick sequential organ failure assessment (qSOFA) score, SOFA score, simplified acute physiology score II (SAPS II), acute physiology and chronic health evaluation scoring system II (APACHE II) score were determined, and the receiver operating characteristic curve (ROC) were used to analyze the prognostic value of the indicators above...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Chanu Rhee, Michael Klompas
New sepsis definitions shift emphasis from the systemic inflammatory response syndrome to organ dysfunction, quantified using the Sequential Organ Failure Assessment (SOFA) score. The new definitions also propose Quick SOFA criteria to rapidly identify potentially infected patients at risk for poor outcomes. The diagnosis of septic shock requires vasopressor dependence and increased lactate levels. Strengths of these definitions include their simplicity and clear association with adverse outcomes. However, their utility in identifying patients with serious infections before frank sepsis ensues remains to be seen...
September 2017: Infectious Disease Clinics of North America
Min Woo Kim, Jee Yong Lim, Sang Hoon Oh
We evaluated the predictive value of serum biomarkers and various clinical risk scales for the 28-day mortality of community-acquired pneumonia (CAP). Serum biomarkers including procalcitonin (PCT) and C-reactive protein (CRP) were evaluated in the emergency department. Scores for the pneumonia severity index (PSI); CURB65 (confusion, urea, respiration, blood pressure; age >65 years); Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) guidelines for severe CAP; Acute Physiology, Chronic Health Evaluation (APACHE) II; Sequential Organ Failure Assessment (SOFA); and quick SOFA (qSOFA) were calculated...
November 2017: Scandinavian Journal of Clinical and Laboratory Investigation
Hyun Kyung Park, Won Young Kim, Myung Chun Kim, Woong Jung, Byuk Sung Ko
PURPOSE: It is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) in predicting organ failure in patients with a suspected infection in an emergency department (ED). METHODS: A retrospective observational study was conducted in an ED during a 9-year period...
December 2017: Journal of Critical Care
Shengbiao Wang, Tao Li, Yunfeng Li, Jianwen Zhang, Xingui Dai
OBJECTIVE: To study the predicting value of four different scoring systems such as the acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, quick SOFA (qSOFA) score and systemic inflammatory response syndrome (SIRS) score for the prognosis of septic patients. METHODS: A retrospective analysis were conducted. Septic patients in intensive care unit (ICU) of the First People's Hospital of Chenzhou form July 1st, 2012 to June 30th, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Xiaotong Hu, Mingjie Wu, Qiang Fang
OBJECTIVE: To clinically validate the precision of diagnostic Sepsis-3 criteria, and to guide and generalize its clinical application. METHODS: A multicenter retrospective observational study was conducted. The patients admitted to intensive care unit (ICU) of 6 tertiary hospitals in Zhejiang Province from January to June 2015 were enrolled, and the patients satisfying the diagnostic criteria of Sepsis-2 and Sepsis-3 were screened. Population characteristics between the patients satisfying two editions were compared, and the diagnosis accuracy rate in different degree hospitals were investigated...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Otavio T Ranzani, Elena Prina, Rosario Menéndez, Adrian Ceccato, Catia Cilloniz, Raul Méndez, Albert Gabarrus, Enric Barbeta, Gianluigi Li Bassi, Miquel Ferrer, Antoni Torres
RATIONALE: The Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. OBJECTIVES: To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia. METHODS: This was a cohort study including adult patients with community-acquired pneumonia from two Spanish university hospitals...
November 15, 2017: American Journal of Respiratory and Critical Care Medicine
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