Ege University, Faculty of Medicine, Department of Emergency Medicine, İzmir, Turkey.
Ege University, Faculty of Medicine, Department of Emergency Medicine, İzmir, Turkey.
Am J Emerg Med. 2021 Oct;48:54-59. doi: 10.1016/j.ajem.2021.04.006. Epub 2021 Apr 6.
This study was aimed to compare the quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS), and National Early Warning Score (NEWS) scoring systems for diagnosing sepsis and predicting mortality and morbidity.
A prospective study was designed. qSOFA, SIRS, and NEWS scores were calculated at the admission. The diagnosis of sepsis was made with SOFA scoring initially. The morbidity and mortality of the patients were identified during follow-up. Also, the sensitivity, specificity, negative predictive value, and positive predictive value of three scoring systems were calculated. The scoring systems were compared with ROC analysis.
A total of 463 patients were evaluated. There were 287 (62.0%) patients diagnosed with sepsis, and septic shock occurred in 64 (13.8%) of patients. Seven-day mortality rate was 8.4% (n = 39), 30-day mortality rate was 18.1% (n = 84). The sensitivity for qSOFA, SIRS, and NEWS for diagnosis of sepsis was 23%, 77%, 58%, and specificity was 99%, 35%, 81% respectively. The sensitivity of the qSOFA, SIRS and NEWS scoring systems for mortality was 39%, 82%, 77% and specificity 91%, 29%, and 64%, respectively. AUROC values for mortality detected as NEWS = 0.772, qSOFA = 0.758, SIRS = 0.542. According to the ROC analysis, the SIRS system was significantly less useful than the qSOFA and NEWS system in the diagnosis of sepsis and mortality (p < 0.0001).
NEWS and qSOFA scoring systems have similar prognosis in both diagnosing sepsis and predicting mortality and both are superior to SIRS.
本研究旨在比较快速序贯器官衰竭评估(qSOFA)、全身炎症反应综合征(SIRS)和英国国家早期预警评分(NEWS)评分系统,以诊断脓毒症和预测死亡率和发病率。
设计了一项前瞻性研究。在入院时计算 qSOFA、SIRS 和 NEWS 评分。最初使用 SOFA 评分诊断脓毒症。在随访期间确定患者的发病率和死亡率。此外,计算了三种评分系统的敏感性、特异性、阴性预测值和阳性预测值。通过 ROC 分析比较评分系统。
共评估了 463 名患者。其中 287 名(62.0%)患者被诊断为脓毒症,64 名(13.8%)患者发生脓毒性休克。7 天死亡率为 8.4%(n=39),30 天死亡率为 18.1%(n=84)。qSOFA、SIRS 和 NEWS 用于诊断脓毒症的敏感性分别为 23%、77%和 58%,特异性分别为 99%、35%和 81%。qSOFA、SIRS 和 NEWS 评分系统对死亡率的敏感性分别为 39%、82%和 77%,特异性分别为 91%、29%和 64%。用于检测死亡率的 AUC 值为 NEWS=0.772、qSOFA=0.758、SIRS=0.542。根据 ROC 分析,SIRS 系统在诊断脓毒症和死亡率方面明显不如 qSOFA 和 NEWS 系统(p<0.0001)。
NEWS 和 qSOFA 评分系统在诊断脓毒症和预测死亡率方面具有相似的预后,两者均优于 SIRS。