COMPARED SIRS, QSOFA AND NEWS AS SCREENING TOOLS FOR DIAGNOSIS SEPSIS IN EMERGENCY DEPARTMENT
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Abstract
BACKGROUND: Sepsis is a serious health problem in the world which increases mortality rate. The effective and accurate screening tool provides early diagnosis early treatment which decrease mortality rate and admission in ICU, but there is still unclear whether SIRS, qSOFA or NEWS is the best method for sepsis screening. This study researched which one of these tools is the most accurate screening tool for diagnose sepsis.
OBJECTIVE: Compared accuracy of SIRS, qSOFA and NEWS as screening tools for diagnosis sepsis by SOFA criteria, predicting admission in ICU and predicting dead in 30 days.
METHODS: A prospective observational trial cohort study was conducted in province hospital, the patient who was suspected sepsis would be screened by the triage nurse with all three screening tools and would be analyzed for outcome regarding sepsis (SOFA score at least 4 or positive hemoculture), ICU admission and death within 30 days.
RESULTS: There were 215 patients in this study. Compared screening tools for diagnosis sepsis in emergency department, NEWS was the highest sensitivity (sensitivity 87.26) and the highest negative predictive value (NPV 45.95), qSOFA was the highest specific (specificity 51.72), the highest positive predictive value (PPV) (PPV 78.12), and the highest positive likelihood ratio (PLR) (PLR 1.26). SIRS was the highest negative likelihood ratio (NLR) (NLR 0.96). qSOFA showed higher overall prognostic accuracy than SIRS and NEWS by comparing AUROC curves.
CONCLUSIONS AND RECOMMENDATIONS: The study shows that qSOFA was the most accurate screening tools for sepsis diagnosis, predicting ICU admission and death within 30 day more than SIRS and NEWS. For the most accurate and early treatment septic patients we should use qSOFA for the first screening tool for diagnosing sepsis.
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