Comparison of SIRS criteria and qSOFA score for identifying sepsis in the Emergency Department

OBJECTIVE: Sepsis is a major cause of death amongst critically ill patients worldwide. Currently, both SIRS criteria and/or qSOFA score are used for identifying sepsis without a uniform standard. The aim of this study is to compare the accuracy of SIRS criteria and qSOFA score by identifying sepsis in undifferentiated patients in the Emergency Department (ED).
DESIGN: A cross-sectional multicenter study.
SETTING: EDs at two European clinical teaching hospitals in the Netherlands.
PARTICIPANTS: In total, 750 adult patients with suspected infection who meet SIRS criteria or have a qualifying qSOFA score who were treated at two EDs in the Netherlands from 1st January 2018 until 1st March 2018 were included.
METHODS: SIRS criteria and qSOFA score were calculated for each patient. The first hospital treated patients who met SIRS criteria following their standardised hospital protocol for sepsis. At the second hospital, only patients who met the qualifying qSOFA score received this treatment. Because of this, patients could be divided into five groups (1: SIRS+, qSOFA-, not treated according protocol (reference group); 2: SIRS+, qSOFA-, treated according protocol; 3: SIRS+, qSOFA+, treated according protocol; 4: SIRS-, qSOFA+, not treated according protocol; 5: SIRS-, qSOFA+, treated according protocol). Patients could be treated outside the protocol when the treating physician considered it necessary.
PRIMARY AND SECONDARY OUTCOME MEASURES: To prove infection was present, positive cultures were used as the primary outcome. Secondary outcomes were in-hospital mortality and ICU admission.

There is no difference between the diagnostic accuracy of SIRS criteria and qSOFA score in identifying sepsis in undifferentiated patients at the ED.

2019-01 data extraction by student
2020-01 analyse
2020-06 writing paper

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