Abstract
Subjects and methods. The mult i-c enter, prospective, and observational trial was conducted. The following data were analyzed in the patients admitted to intensive care wards: number of q SOFA scores, the presence of SIRS criteria, levels of lactate, procalcitonin, C-r eactive protein in blood, the presence of sepsis according to Sepsi s-3 criteria. The value of q SOFA scores, SIRS criteria, and biomarkers for sepsis diagnostics was assessed by means of RO C -a nalysis. Results. The following areas under RO C -c urves were defined during diagnostics of sepsis in the patients in intensive care wards: q SOFA – 0.679 (95% CI 0.646–0.712); SIRS – 0.714 (95% CI 0.682–0.745), p = 0.099; when q SOFA exceeding 1 score: procalcitonin – 0.788 (95% CI 0.689–0.867), C-r eactive protein – 0.787 (95% CI 0.688–0.866), p = 0.970. Conclusion. q SOFA score is compatible with SIRS criteria for diagnostics of sepsis among the patients in intensive care wards. q SOFA score is highly sensitive, but it is of low specificity for sepsis diagnostics. Should there be at least 1 score of q SOFA , it is recommended to test levels of procalcitonin or C-r eactive protein in order to increase the specificity of this score for diagnostics of sepsis.
Highlights
The following areas under Receiver operating characteristic (ROC)-curves were defined during diagnostics of sepsis in the patients in intensive care wards: quick Sequential Organ Failure Assessment (qSOFA) – 0.679 (95%CI 0.646–0.712); systemic inflammatory response syndrome (SIRS) – 0.714, p = 0.099; when qSOFA exceeding 1 score: procalcitonin – 0.788, C-reactive protein – 0.787, p = 0.970
Conclusion. qSOFA score is compatible with SIRS criteria for diagnostics of sepsis among the patients in intensive care wards. qSOFA score is highly sensitive, but it is of low specificity for sepsis diagnostics
Should there be at least 1 score of qSOFA, it is recommended to test levels of procalcitonin or C-reactive protein in order to increase the specificity of this score for diagnostics of sepsis
Summary
QSOFA score is compatible with SIRS criteria for diagnostics of sepsis among the patients in intensive care wards. Известна концепция «Сепсис-1», основанная на идентификации критериев SIRS (Systemic Inflammatory Response Syndrome) для диагностики сепсиса у пациентов с инфекцией [4]. Международная группа экспертов сформулировала новую концепцию для идентификации пациентов с сепсисом, названную «Сепсис-3» [24]. Идентифицировано, что в общей популяции пациентов (в ОРИТ и вне ОРИТ) наличие по крайней мере 2 баллов по шкале qSOFA оптимальным образом позволяет выявить пациентов с повышенным риском смерти. Что шкала qSOFA превосходит критерии SIRS в прогнозе летальности у пациентов с инфекцией вне ОРИТ и может быть сравнима со шкалой SOFA у пациентов некоторых категорий [20, 24]. Цель исследования: оценить информационную ценность шкалы qSOFA в диагностике сепсиса у пациентов, госпитализированных в отделения реанимации и интенсивной терапии лечебных учреждений Российской Федерации
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