Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study
Introduction The aim of the study was to compare the Quick Sequential Organ Failure Assessment tools (qSOFA), and Quick Sequential Organ Failure Assessment-Lactate (LqSOFA) to detect pre-hospital sepsis among patients with or without suspicion of infection. Material and methods Multicenter prospect...
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Termedia Publishing House
2020-02-01
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| Series: | Archives of Medical Science |
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| Online Access: | https://www.archivesofmedicalscience.com/Head-to-head-comparison-of-pre-hospital-qSOFA-and-lactate-qSOFA-for-predicting-sepsis,116676,0,2.html |
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| author | Francisco Martín-Rodríguez Raúl López-Izquierdo Miguel A. Castro Villamor Carlos delPozo-Vegas Irene Sánchez-Soberón Juan F. Delgado-Benito Virginia Carbajosa Rodíguez Rodrigues Leonardo José Luis Martín-Conty |
| author_facet | Francisco Martín-Rodríguez Raúl López-Izquierdo Miguel A. Castro Villamor Carlos delPozo-Vegas Irene Sánchez-Soberón Juan F. Delgado-Benito Virginia Carbajosa Rodíguez Rodrigues Leonardo José Luis Martín-Conty |
| author_sort | Francisco Martín-Rodríguez |
| collection | DOAJ |
| description | Introduction
The aim of the study was to compare the Quick Sequential Organ Failure Assessment tools (qSOFA), and Quick Sequential Organ Failure Assessment-Lactate (LqSOFA) to detect pre-hospital sepsis among patients with or without suspicion of infection.
Material and methods
Multicenter prospective cohort study in non-traumatic patients attended by Advanced Life Support in the prehospital environment and transferred to the hospital. We collected demographic, physiological, clinical, and analytical variables, main diagnosis, hospital admission and clinical diagnosis of sepsis. Primary outcome was the clinical diagnosis of sepsis in the hospital.
Results
Between March 1, 2018 and March 31, 2019, we included in our study 1548 participants of whom 82 (5.3%) received a final hospital diagnosis of sepsis. The qSOFA presented an area under the receiver operating characteristic curve (AUROC) to detect sepsis in patients with suspicion and without suspicion of infection of 0.757 (95% CI: 0.65–0.81), compared to LqSOFA with an AUROC to detect sepsis of 0.784 (95% CI: 0.72–0.84). In the group of patients with suspected infection, the LqSOFA for a 2-point cut-off presented an AUROC of 0.773 (95% CI: 0.69–0.85), with an excellent sensitivity of 92.6% (95% CI: 83.9–96.8) and an odds ratio of 8.23 (95% CI: 3.09–21.92).
Conclusions
An appropriate strategy for reducing the morbidity and mortality from sepsis must necessarily include the prompt identification of this time-dependent pathology by using all the tools at our disposal. The qSOFA and
LqSOFA can be used in the prehospital environment and help the diagnosis of suspected sepsis in patients with medical pathology, highlighting the predictive capacity of LqSOFA in the group of patients with suspected infection. |
| format | Article |
| id | doaj-art-be5c7e5e2f4043abb9f634f830b083ce |
| institution | Kabale University |
| issn | 1734-1922 1896-9151 |
| language | English |
| publishDate | 2020-02-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj-art-be5c7e5e2f4043abb9f634f830b083ce2025-01-27T10:44:31ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512020-02-012051547155510.5114/aoms.2020.92901116676Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort studyFrancisco Martín-Rodríguez0Raúl López-Izquierdo1Miguel A. Castro Villamor2Carlos delPozo-Vegas3Irene Sánchez-Soberón4Juan F. Delgado-Benito5Virginia Carbajosa Rodíguez6Rodrigues Leonardo7José Luis Martín-Conty8Advanced Clinical Simulation Center, Faculty of Medicine, Universidad de Valladolid, Valladolid, SpainEmergency Department, Hospital Universitario Rio Horteg, Valladolid, SpainAdvanced Clinical Simulation Center, Faculty of Medicine, Universidad de Valladolid, Valladolid, SpainEmergency Department, Hospital Clínico Universitario, Valladolid, SpainEmergency Medical Services, Gerencia de Emergencias Sanitarias de Castilla y León, Valladolid, SpainEmergency Medical Services, Gerencia de Emergencias Sanitarias de Castilla y León, Valladolid, SpainEmergency Department, Hospital Universitario Rio Horteg, Valladolid, SpainSurgery Department, Hospital Sanatorio de Luanda, Angola, SpainFaculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, SpainIntroduction The aim of the study was to compare the Quick Sequential Organ Failure Assessment tools (qSOFA), and Quick Sequential Organ Failure Assessment-Lactate (LqSOFA) to detect pre-hospital sepsis among patients with or without suspicion of infection. Material and methods Multicenter prospective cohort study in non-traumatic patients attended by Advanced Life Support in the prehospital environment and transferred to the hospital. We collected demographic, physiological, clinical, and analytical variables, main diagnosis, hospital admission and clinical diagnosis of sepsis. Primary outcome was the clinical diagnosis of sepsis in the hospital. Results Between March 1, 2018 and March 31, 2019, we included in our study 1548 participants of whom 82 (5.3%) received a final hospital diagnosis of sepsis. The qSOFA presented an area under the receiver operating characteristic curve (AUROC) to detect sepsis in patients with suspicion and without suspicion of infection of 0.757 (95% CI: 0.65–0.81), compared to LqSOFA with an AUROC to detect sepsis of 0.784 (95% CI: 0.72–0.84). In the group of patients with suspected infection, the LqSOFA for a 2-point cut-off presented an AUROC of 0.773 (95% CI: 0.69–0.85), with an excellent sensitivity of 92.6% (95% CI: 83.9–96.8) and an odds ratio of 8.23 (95% CI: 3.09–21.92). Conclusions An appropriate strategy for reducing the morbidity and mortality from sepsis must necessarily include the prompt identification of this time-dependent pathology by using all the tools at our disposal. The qSOFA and LqSOFA can be used in the prehospital environment and help the diagnosis of suspected sepsis in patients with medical pathology, highlighting the predictive capacity of LqSOFA in the group of patients with suspected infection.https://www.archivesofmedicalscience.com/Head-to-head-comparison-of-pre-hospital-qSOFA-and-lactate-qSOFA-for-predicting-sepsis,116676,0,2.htmlprehospital caresepsispoint-of-care testingwarning scoreclinical decision |
| spellingShingle | Francisco Martín-Rodríguez Raúl López-Izquierdo Miguel A. Castro Villamor Carlos delPozo-Vegas Irene Sánchez-Soberón Juan F. Delgado-Benito Virginia Carbajosa Rodíguez Rodrigues Leonardo José Luis Martín-Conty Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study Archives of Medical Science prehospital care sepsis point-of-care testing warning score clinical decision |
| title | Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study |
| title_full | Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study |
| title_fullStr | Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study |
| title_full_unstemmed | Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study |
| title_short | Head-to-head comparison of pre-hospital qSOFA and lactate-qSOFA for predicting sepsis in patients with and without suspected infection. A multicenter prospective cohort study |
| title_sort | head to head comparison of pre hospital qsofa and lactate qsofa for predicting sepsis in patients with and without suspected infection a multicenter prospective cohort study |
| topic | prehospital care sepsis point-of-care testing warning score clinical decision |
| url | https://www.archivesofmedicalscience.com/Head-to-head-comparison-of-pre-hospital-qSOFA-and-lactate-qSOFA-for-predicting-sepsis,116676,0,2.html |
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