SESSION TITLE: Critical Care 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: A revision of sepsis definitions proposed the Quick Sequential Organ Function Assessment (qSOFA) as a bedside indicator of sepsis. But practical application is not well established in the Emergency Department (ED). We aimed to elucidate modified CRB-65 (mCRB-65) score in recognizing sepsis compared to systemic inflammatory response syndrome (SIRS) and qSOFA. METHODS: A retrospective chart review was performed among patients with suspected or documented infection between January 2014 and December 2015. We assigned each patient into the sepsis and the no-sepsis group by the presence of predefined organ dysfunction. The number of SIRS, qSOFA, mCRB-65 criteria was calculated for each patient. And we then calculated the sensitivity and specificity of predefined criteria for each score for prediction of sepsis in our data set, and compared an area under the curve (AUC) for each score. In addition, we performed the matched case-control study through using the propensity score matching method. More than 2 points in three tools was considered as positive for risk of sepsis. RESULTS: A total of 4,253 patients with pneumonia were assessed for eligibility, and 2,441 of whom (933 with sepsis and 1,508 with no-sepsis) were included in the study. Of these patients, the rate of patients met mCRB-65, qSOFA, and SIRS positive criteria was 37.6%, 12.3%, and 52.3%, respectively. The crude AUC value of mCRB-65 positive criteria in predicting sepsis was significantly higher than that of qSOFA and SIRS positive criteria (0.728 vs. 0.633. vs. 0.608, respectively). After the propensity score matching process, the rate of patients met mCRB-65, qSOFA, and SIRS positive criteria was 49.2%, 15.8%, and 56.5%, respectively. With respect to mCRB-65, qSOFA, and SIRS positive criteria, the sensitivity for sepsis were 0.66 (95% CI, 0.63 to 0.69), 0.29 (95% CI, 0.26 to 0.32), and 0.66 (95% CI, 0.62 to 0.69), respectively. And for positive criteria of three tools, the specificity for sepsis were 0.72 (95% CI, 0.69 to 0.75), 0.96 (95% CI, 0.95 to 0.97), and 0.54 (95% CI, 0.50 to 0.57), respectively. And mCRB-65 positive criteria still showed higher discrimination for prediction sepsis compared to qSOFA and SIRS positive criteria (adjusted AUC 0.688 vs. 0.630 vs. 0.596, respectively) CONCLUSIONS: Proposed mCRB-65 score seemed to provide better discrimination than SIRS and qSOFA for predicting sepsis. After adjustment of baseline variables, high discrimination of mCRB-65 was still maintained. This may have quality improvement implications in predicting sepsis. CLINICAL IMPLICATIONS: Our findings suggest that this simple screening tool might be helpful for physicians to identify sepsis promptly and to escalate therapy appropriately in initial ED. DISCLOSURES: No relevant relationships by Jonghoo Lee, source=Web Response no disclosure on file for Jae-Uk Song