Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis
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 popula...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-021-00532-1 |
| _version_ | 1819009366251012096 |
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| author | Jorge Clar María Rosa Oltra Raquel Benavent Carolina Pinto Adrian Ruiz Maria Teresa Sanchez Jose Noceda Josep Redon Maria Jose Forner |
| author_facet | Jorge Clar María Rosa Oltra Raquel Benavent Carolina Pinto Adrian Ruiz Maria Teresa Sanchez Jose Noceda Josep Redon Maria Jose Forner |
| author_sort | Jorge Clar |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T00:55:13Z |
| format | Article |
| id | doaj.art-ea01235cfe62424b9884d677bc72f8a6 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-21T00:55:13Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-ea01235cfe62424b9884d677bc72f8a62022-12-21T19:21:18ZengBMCBMC Emergency Medicine1471-227X2021-12-0121111110.1186/s12873-021-00532-1Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsisJorge Clar0María Rosa Oltra1Raquel Benavent2Carolina Pinto3Adrian Ruiz4Maria Teresa Sanchez5Jose Noceda6Josep Redon7Maria Jose Forner8Clinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaClinic Hospital. University of ValenciaAbstract 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.https://doi.org/10.1186/s12873-021-00532-1MortalityPrognosisSepsisCommunity-acquired sepsisDiagnostic scales |
| spellingShingle | Jorge Clar María Rosa Oltra Raquel Benavent Carolina Pinto Adrian Ruiz Maria Teresa Sanchez Jose Noceda Josep Redon Maria Jose Forner Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis BMC Emergency Medicine Mortality Prognosis Sepsis Community-acquired sepsis Diagnostic scales |
| title | Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis |
| title_full | Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis |
| title_fullStr | Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis |
| title_full_unstemmed | Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis |
| title_short | Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis |
| title_sort | prognostic value of diagnostic scales in community acquired sepsis mortality at an emergency service prognosis in community adquired sepsis |
| topic | Mortality Prognosis Sepsis Community-acquired sepsis Diagnostic scales |
| url | https://doi.org/10.1186/s12873-021-00532-1 |
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