Abstract
Objective: To determine the association between 30-day mortality with Systemic Inflammatory Response Syndrome (SIRS), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA) in emergency department patients with pneumonia. Secondary outcomes included the association of sepsis scores with hospital admission and direct ICU admission.
Highlights
The 2016 Sepsis-3 consensus statement removed the Systemic Inflammatory Response Syndrome (SIRS) criteria from the definition of sepsis, in part for its poor specificity. [1, 2] In its place, Sepsis-3 recommended the Sequential Organ Failure Assessment (SOFA) be used to assist in identifying sepsis among patients with infection
Because we anticipate calculation of quick SOFA (qSOFA) and SOFA will soon become common in the emergency department (ED), we investigated whether these scores would offer any value in pneumonia triage
Of patients with positive qSOFA, 91% had organ dysfunction compared to 70% for positive SIRS
Summary
The 2016 Sepsis-3 consensus statement removed the Systemic Inflammatory Response Syndrome (SIRS) criteria from the definition of sepsis, in part for its poor specificity. [1, 2] In its place, Sepsis-3 recommended the Sequential Organ Failure Assessment (SOFA) be used to assist in identifying sepsis among patients with infection. The SOFA score better identified patients at risk of sepsis, as well as its associated organ dysfunction and mortality risk. [3] Because SOFA is more time and resource intensive than SIRS and is not fully calculable pre-hospital or at initial emergency department (ED) triage, the Sepsis-3 group developed the quick SOFA (qSOFA). [4, 5] Several pneumonia mortality risk scores are used in the ED to guide disposition and management. Because we anticipate calculation of qSOFA and SOFA will soon become common in the ED, we investigated whether these scores would offer any value in pneumonia triage. In a large population of ED patients with pneumonia, we aimed to determine how well SIRS, SOFA, and qSOFA correlate with 30 day all-cause mortality, ED disposition, and intensive care unit (ICU) admission
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