Predictive Value of Quick Sepsis-Related Organ Failure Scores following Sepsis-Related Medical Emergency Team Calls: A Retrospective Cohort Study. Issue 6 (November 2017)

• Record Type: Journal Article
• Authors: Boulos, D.; Shehabi, Y.; Moghaddas, J. A.; Birrell, M.; Choy, A.; Giang, V.; Nguyen, J.; Hall, T.; Le, S.
• Is Part Of: Anaesthesia and intensive care. Volume 45:Issue 6(2017)
• Page Start: 688
• Page End: 694
• Publication Date: 2017-11
• Subjects: sepsis -- hospital rapid response team -- systemic inflammatory response syndrome -- risk assessment -- mortality; Anesthesiology -- Periodicals; Intensive Care Units -- Periodicals; 617.96
• DOI: 10.1177/0310057X1704500607
• Languages: English
• ISSNs: 0310-057X

Abstract

We conducted a cohort study of adult ward patients who had a Medical Emergency Team (MET) call triggered by confirmed or suspected sepsis in an Australian tertiary centre to assess the predictive utility of systemic inflammatory response syndrome (SIRS) and quick Sepsis-Related Organ Failure Assessment (qSOFA) scores for 28-day mortality over a 12-month period. Sepsis was the causative aetiology in 970 MET calls for 646 patients with a mean age of 68 years and median Charlson Comorbidity score (CCS) of 3.0. Four hundred and seven (63%) patients had microbiological identification of a causative organism with 35 (9%) demonstrating multi–drug resistance. The 28-day mortality rate was 22%. Independent risk factors for 28-day mortality included age (incidence rate ratio [IRR] 1.038; P <0.001) and CCS (IRR 1.102; P <0.001). qSOFA positive patients had a threefold risk of 28-day mortality compared to those who were negative (IRR 3.15; P=0.02). Both the SIRS and qSOFA score had poor sensitivity (86% versus 62%, respectively) for mortality as a sole diagnostic tool and should be investigated as part of a multiparameter panel within a large prospective study.