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Observational Study
. 2021 Dec 18;21(1):161.
doi: 10.1186/s12873-021-00532-1.

Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis

Jorge Clar  1 , María Rosa Oltra  1 , Raquel Benavent  1 , Carolina Pinto  1 , Adrian Ruiz  1 , Maria Teresa Sanchez  1 , Jose Noceda  1 , Josep Redon  2   3   4 , Maria Jose Forner  1
Affiliations
Observational Study

Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis

Jorge Clar et al. BMC Emerg Med. .

Abstract

Objectives: To asses the prognostic value of diagnostic scales in mortality of community-adquired sepsis and added value of additional parameters.

Methods: Prospective observational study of patients with community-adquired sepsis in the Emergency Room of University Hospital. The study population were patients presented in the Emergency Room with confirmed infection and practicians sepsis diagnosis. Demographics, triage vital signs, inhaled oxygen fraction, inflammatory markers, biochemistry, all-cause mortality during hospitalization and three months after were recorded. Prognostic value of qSOFA, NEWS, SOFA, SIRS, and amplified scales were calculated by using logistic regression and ROC curves.

Results: 201 patients, 54% male, average age 77±11,2 years were included. Sixty-three (31.5%) died during hospitalization and 24 (12%) three months after discharge. At the time of admission vital signs related with in-hospital mortality were Glasgow Coma Scale <13, respiratory rate ≥22 bpm, temperature, oxygen desaturation, high flow oxygen therapy and heart rate. Patients dead in-hospital had lower PaCO2, higher lactate, glucose and creatinine. Greater predictive capacity of the scales, from higher to lower, was: qSOFA, NEWS2, SOFA and SIRS. Amplified scales with lactate >2mg/dl, glucose, blood level >190mg/dl and PaCO2 <35mmHg improved predictive value.

Conclusion: Amplified-qSOFA and amplified-NEWS2 scales at Emergency Department may offer a better prognostic of septic patients mortality.

Keywords: Community-acquired sepsis; Diagnostic scales; Mortality; Prognosis; Sepsis.

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Conflict of interest statement

Authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
Flow chart
Fig. 2
Fig. 2
Sepsis scales
Fig. 3
Fig. 3
ROC curve for in-hospital mortality according of each scale
See this image and copyright information in PMC

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