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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2021

Open Access 01-12-2021 | Septicemia | Research

Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis

Authors: Jorge Clar, María Rosa Oltra, Raquel Benavent, Carolina Pinto, Adrian Ruiz, Maria Teresa Sanchez, Jose Noceda, Josep Redon, Maria Jose Forner

Published in: BMC Emergency Medicine | Issue 1/2021

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Abstract

Objectives

To asses the prognostic value of diagnostic scales in mortality of community-adquired sepsis and added value of additional parameters.

Methods

Prospective observational study of patients with community-adquired sepsis in the Emergency Room of University Hospital. The study population were patients presented in the Emergency Room with confirmed infection and practicians sepsis diagnosis. Demographics, triage vital signs, inhaled oxygen fraction, inflammatory markers, biochemistry, all-cause mortality during hospitalization and three months after were recorded. Prognostic value of qSOFA, NEWS, SOFA, SIRS, and amplified scales were calculated by using logistic regression and ROC curves.

Results

201 patients, 54% male, average age 77±11,2 years were included. Sixty-three (31.5%) died during hospitalization and 24 (12%) three months after discharge. At the time of admission vital signs related with in-hospital mortality were Glasgow Coma Scale <13, respiratory rate ≥22 bpm, temperature, oxygen desaturation, high flow oxygen therapy and heart rate. Patients dead in-hospital had lower PaCO2, higher lactate, glucose and creatinine. Greater predictive capacity of the scales, from higher to lower, was: qSOFA, NEWS2, SOFA and SIRS. Amplified scales with lactate >2mg/dl, glucose, blood level >190mg/dl and PaCO2 <35mmHg improved predictive value.

Conclusion

Amplified-qSOFA and amplified-NEWS2 scales at Emergency Department may offer a better prognostic of septic patients mortality.
Appendix
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Metadata
Title
Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis
Authors
Jorge Clar
María Rosa Oltra
Raquel Benavent
Carolina Pinto
Adrian Ruiz
Maria Teresa Sanchez
Jose Noceda
Josep Redon
Maria Jose Forner
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2021
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-021-00532-1

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