A Comparison of qSOFA and SIRS in the Early Diagnosis of Severe Pneumococcal Sepsis: A Retrospective Cohort Study

Rein Pernille Ursin,Dunlop Oona,Djordjilović Vera,Ormaasen Vidar,Jacobsen Dag

doi:10.23937/2377-4630/1410111

Abstract

In 2016 quick Sequential Sepsis-related Organ Failure Assessment (qSOFA) was presented as a simple bedside screening tool in identifying sepsis and is now replacing the Systemic Inflammatory Response Syndrome (SIRS) criteria in many Emergency Departments. We wanted to study whether these diagnostic criteria were sensitive enough to identify sepsis on the initial hospital admission in a cohort of patients who rapidly developed pneumococcal septic shock.

Highlights

Sepsis criteria are important: As bedside diagnostic tools to identify septic patients, as disease-defining criteria in research and in severity scoring/mortality prediction
We used the definitions for severe sepsis and septic shock that were defined together with the Systemic Inflammatory Response Syndrome (SIRS) criteria in 1992; severe sepsis was defined as sepsis associated with organ dysfunction, hypoperfusion or hypotension and septic shock was defined as the need for treatment with vasopressor despite adequate fluid resuscitation [1]
We retrospectively studied the ability of quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) and SIRS criteria to identify sepsis at admission in a previously described cohort of all eligible adult patients with severe pneumococcal sepsis (38 patients) admitted to the Medical Intensive Care Unit (MICU) at Oslo University Hospital (OUH) Ullevaal in an eight-year period (01/01/2006-12/31/2013) [18]

Summary

Introduction

Sepsis criteria are important: As bedside diagnostic tools to identify septic patients, as disease-defining criteria in research and in severity scoring/mortality prediction. The Systemic Inflammatory Response Syndrome (SIRS) criteria were introduced in 1992 [1]. In 2016 Sepsis-3 was presented; Sequential [Sepsis-related] Organ Failure Assessment (SOFA) and quickSOFA (qSOFA) scores were defined as the new sepsis criteria instead of SIRS [3]. In 2016 quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) was presented as a simple bedside screening tool in identifying sepsis and is replacing the Systemic Inflammatory Response Syndrome (SIRS) criteria in many Emergency Departments. We wanted to study whether these diagnostic criteria were sensitive enough to identify sepsis on the initial hospital admission in a cohort of patients who rapidly developed pneumococcal septic shock

Objectives

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Discussion

Conclusion