Comparison of the systematic Inflammatory response syndrome and the quick sequential organ failure assessment for prognostic accuracy in detecting sepsis in the emergency department: A systematic review. (January 2023)

• Record Type: Journal Article
• Authors: Svendsen, Marius; Steindal, Simen A.; Hamilton Larsen, Marie; Trygg Solberg, Marianne
• Is Part Of: International emergency nursing. Volume 66(2023)
• Publication Date: 2023-01
• Subjects: Emergency department -- Predictive value -- Prognostic accuracy -- qSOFA -- Sensitivity -- Sepsis -- SIRS -- Specificity -- Systematic review; CASP Critical Appraisal Skills Programme -- CI Confidence interval -- ED Emergency Department -- ESI Emergency Severity Index -- GCS Glasgow Coma Scale -- ICU Intensive Care Unit -- kPa Kilopascal -- mmHg Millimeter of mercury -- MAP mean arterial pressure (MAP) -- NPV Negative Predictive Value -- PaCO2 arterial partial pressure of carbon dioxide -- PICO Patient, intervention, Comparison, Outcome -- PPV Positive Predictive Value -- PV Predictive Value -- qSOFA quick sequential organ failure assessment -- SD Standard Deviation -- SIRS Systemic Inflammatory response syndrome -- SOFA sequential Organ Failure Assessment; Emergency nursing -- Periodicals; 616.025
• DOI: 10.1016/j.ienj.2022.101242
• Languages: English
• ISSNs: 1755-599X

Abstract

Highlights: Sepsis is one of the most common causes of death worldwide, and severe sepsis accounts for two-thirds of in-hospital deaths. Awareness and prompt recognition of sepsis is essential for nurses and physicians working in the emergency department. Emergency department nurses and physicians needs a reliable sepsis screening tool, due to the unspecific clinical presentation of sepsis. The screening tool Systemic Inflammatory Response Syndrome (SIRS) or the Quick Sequential Organ Failure Assessment tool (qSOFA) can be used to detect sepsis in the emergency department. The screening tool qSOFA is a better-suited screening tool than SIRS for prognostic accuracy in detecting sepsis in the emergency department. Abstract: Background: Awareness and prompt recognition of sepsis are essential for nurses working in the emergency department (ED), enabling them to make an initial assessment of patients and then to sort them according to their condition s severity. The aim of this systematic review was to investigate prognostic accuracy in detecting sepsis in the emergency department by comparing the previous sepsis-2 screening tool, the Systemic Inflammatory Response Syndrome (SIRS) and the current sepsis-3 screening tool, the Quick Sequential Organ Failure Assessment (qSOFA). Methods: This systematic review used the guideline by Bettany-Saltikov and McSherry and was reported according to the Preferred Reporting Items for Systematic Reviews and meta-Analyses (PRISMA) 2020 checklist. The protocol was registered in PROSPERO. A systematic search was conducted using the CINAHL, EMBASE and MEDLINE databases. Study selection and risk of bias was performed independently by pair of authors. Results: Five articles were included. Overall, SIRS showed higher sensitivity than qSOFA, while qSOFA showed higher specificity than SIRS. The positive predictive value for qSOFA was superior, while there was a minor deviation in negative predictive value between qSOFA and SIRS. Conclusion: The overall recommendation based on the included studies indicates that qSOFA is the better-suited screening tool for prognostic accuracy in detecting sepsis in the emergency department.