Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study

Article Subjects > Biomedicine Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and books
Universidad Internacional do Cuanza > Research > Scientific Production
Abierto Inglés Background: Nowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality. Methods: Prospective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients (n = 535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used. Results: The mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841–0.913), 0.761 (95%CI 0.706–0.816), 0.731 (95%CI 0.674–0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA’s AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results. Conclusion: The use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario. metadata Melero-Guijarro, Laura and Sanz-García, Ancor and Martín-Rodríguez, Francisco and Lipari, Vivian and Mazas Pérez-Oleaga, Cristina and Carvajal-Altamiranda, Stefanía and Martínez López, Nohora Milena and Dominguez Azpíroz, Irma and Castro Villamor, Miguel A. and Sánchez Soberón, Irene and López-Izquierdo, Raúl mail UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, vivian.lipari@uneatlantico.es, cristina.mazas@uneatlantico.es, stefania.carvajal@uneatlantico.es, nohora.martinez@uneatlantico.es, irma.dominguez@unini.edu.mx, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED (2023) Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study. Frontiers in Medicine, 10. ISSN 2296-858X

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Abstract

Background: Nowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality. Methods: Prospective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients (n = 535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used. Results: The mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841–0.913), 0.761 (95%CI 0.706–0.816), 0.731 (95%CI 0.674–0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA’s AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results. Conclusion: The use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario.

Item Type: Article
Uncontrolled Keywords: sepsis, early warning scores, septic shock, point-of-care testing, mSOFA, prehospital
Subjects: Subjects > Biomedicine
Divisions: Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and books
Universidad Internacional do Cuanza > Research > Scientific Production
Date Deposited: 18 Apr 2023 23:30
Last Modified: 21 Oct 2024 23:30
URI: https://repositorio.unib.org/id/eprint/6789

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