Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection
Abstract Previous studies have shown inconsistent prognostic accuracy for mortality with both quick sequential organ failure assessment (qSOFA) and the systemic inflammatory response syndrome (SIRS) criteria. We aimed to validate the accuracy of qSOFA and the SIRS criteria for predicting in-hospital...
Main Authors: | , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Nature Publishing Group
2021-03-01
|
Series: | Scientific Reports |
Online Access: | https://doi.org/10.1038/s41598-021-84743-3 |
id |
doaj-edd941345d634ae99d39603a24e8de32 |
---|---|
record_format |
Article |
spelling |
doaj-edd941345d634ae99d39603a24e8de322021-03-11T12:21:27ZengNature Publishing GroupScientific Reports2045-23222021-03-011111910.1038/s41598-021-84743-3Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infectionAtsushi Shiraishi0Satoshi Gando1Toshikazu Abe2Shigeki Kushimoto3Toshihiko Mayumi4Seitaro Fujishima5Akiyoshi Hagiwara6Yasukazu Shiino7Shin-ichiro Shiraishi8Toru Hifumi9Yasuhiro Otomo10Kohji Okamoto11Junichi Sasaki12Kiyotsugu Takuma13Kazuma Yamakawa14Yoshihiro Hanaki15Masahiro Harada16Kazuma Morino17Emergency and Trauma Center, Kameda Medical CenterDivision of Acute and Critical Care Medicine, Hokkaido University Graduate School of MedicineDepartment of General Medicine, Juntendo UniversityDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of MedicineDepartment of Emergency Medicine, School of Medicine, University of Occupational and Environmental HealthCenter for General Medicine Education, Keio University School of MedicineCenter Hospital of the National Center for Global Health and MedicineDepartment of Acute Medicine, Kawasaki Medical SchoolDepartment of Emergency and Critical Care Medicine, Aizu Chuo HospitalDepartment of Emergency and Critical Care Medicine, St. Luke’s International HospitalTrauma and Acute Critical Care Center, Medical Hospital, Tokyo Medical and Dental UniversityDepartment of Surgery, Center for Gastroenterology and Liver Disease, Kitakyushu City Yahata HospitalDepartment of Emergency and Critical Care Medicine, Keio University School of MedicineEmergency and Critical Care Center, Kawasaki Municipal Kawasaki HospitalDivision of Trauma and Surgical Critical Care, Osaka General Medical CenterDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Nagoya Daiichi HospitalDepartment of Emergency and Critical Care, National Hospital Organization Kumamoto Medical CenterMedical Center for Emergency, Yamagata Prefectural Central HospitalAbstract Previous studies have shown inconsistent prognostic accuracy for mortality with both quick sequential organ failure assessment (qSOFA) and the systemic inflammatory response syndrome (SIRS) criteria. We aimed to validate the accuracy of qSOFA and the SIRS criteria for predicting in-hospital mortality in patients with suspected infection in the emergency department. A prospective study was conducted including participants with suspected infection who were hospitalised or died in 34 emergency departments in Japan. Prognostic accuracy of qSOFA and SIRS criteria for in-hospital mortality was assessed by the area under the receiver operating characteristic (AUROC) curve. Of the 1060 participants, 402 (37.9%) and 915 (86.3%) had qSOFA ≥ 2 and SIRS criteria ≥ 2 (given thresholds), respectively, and there were 157 (14.8%) in-hospital deaths. Greater accuracy for in-hospital mortality was shown with qSOFA than with the SIRS criteria (AUROC: 0.64 versus 0.52, difference + 0.13, 95% CI [+ 0.07, + 0.18]). Sensitivity and specificity for predicting in-hospital mortality at the given thresholds were 0.55 and 0.65 based on qSOFA and 0.88 and 0.14 based on SIRS criteria, respectively. To predict in-hospital mortality in patients visiting to the emergency department with suspected infection, qSOFA was demonstrated to be modestly more accurate than the SIRS criteria albeit insufficiently sensitive. Clinical Trial Registration: The study was pre-registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000027258).https://doi.org/10.1038/s41598-021-84743-3 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Yasukazu Shiino Shin-ichiro Shiraishi Toru Hifumi Yasuhiro Otomo Kohji Okamoto Junichi Sasaki Kiyotsugu Takuma Kazuma Yamakawa Yoshihiro Hanaki Masahiro Harada Kazuma Morino |
spellingShingle |
Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Yasukazu Shiino Shin-ichiro Shiraishi Toru Hifumi Yasuhiro Otomo Kohji Okamoto Junichi Sasaki Kiyotsugu Takuma Kazuma Yamakawa Yoshihiro Hanaki Masahiro Harada Kazuma Morino Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection Scientific Reports |
author_facet |
Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Yasukazu Shiino Shin-ichiro Shiraishi Toru Hifumi Yasuhiro Otomo Kohji Okamoto Junichi Sasaki Kiyotsugu Takuma Kazuma Yamakawa Yoshihiro Hanaki Masahiro Harada Kazuma Morino |
author_sort |
Atsushi Shiraishi |
title |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
title_short |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
title_full |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
title_fullStr |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
title_full_unstemmed |
Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
title_sort |
quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-03-01 |
description |
Abstract Previous studies have shown inconsistent prognostic accuracy for mortality with both quick sequential organ failure assessment (qSOFA) and the systemic inflammatory response syndrome (SIRS) criteria. We aimed to validate the accuracy of qSOFA and the SIRS criteria for predicting in-hospital mortality in patients with suspected infection in the emergency department. A prospective study was conducted including participants with suspected infection who were hospitalised or died in 34 emergency departments in Japan. Prognostic accuracy of qSOFA and SIRS criteria for in-hospital mortality was assessed by the area under the receiver operating characteristic (AUROC) curve. Of the 1060 participants, 402 (37.9%) and 915 (86.3%) had qSOFA ≥ 2 and SIRS criteria ≥ 2 (given thresholds), respectively, and there were 157 (14.8%) in-hospital deaths. Greater accuracy for in-hospital mortality was shown with qSOFA than with the SIRS criteria (AUROC: 0.64 versus 0.52, difference + 0.13, 95% CI [+ 0.07, + 0.18]). Sensitivity and specificity for predicting in-hospital mortality at the given thresholds were 0.55 and 0.65 based on qSOFA and 0.88 and 0.14 based on SIRS criteria, respectively. To predict in-hospital mortality in patients visiting to the emergency department with suspected infection, qSOFA was demonstrated to be modestly more accurate than the SIRS criteria albeit insufficiently sensitive. Clinical Trial Registration: The study was pre-registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000027258). |
url |
https://doi.org/10.1038/s41598-021-84743-3 |
work_keys_str_mv |
AT atsushishiraishi quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT satoshigando quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT toshikazuabe quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT shigekikushimoto quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT toshihikomayumi quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT seitarofujishima quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT akiyoshihagiwara quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT yasukazushiino quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT shinichiroshiraishi quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT toruhifumi quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT yasuhirootomo quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT kohjiokamoto quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT junichisasaki quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT kiyotsugutakuma quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT kazumayamakawa quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT yoshihirohanaki quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT masahiroharada quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection AT kazumamorino quicksequentialorganfailureassessmentversussystemicinflammatoryresponsesyndromecriteriaforemergencydepartmentpatientswithsuspectedinfection |
_version_ |
1724224421306040320 |