Evaluation of qSOFA combined with inflammatory mediators for diagnosing sepsis and predicting mortality among emergency department

Ling, Huaxiang1; Chen, Manqin2; Dai, JunJie3; Zhong, Haimei4; Chen, Rongchang3; Shi, Fei2

2023-04-01

10.1016/j.cca.2023.117352

CLINICA CHIMICA ACTA   影响因子和分区

0009-8981

1873-3492

Background: There are no guidelines in China or worldwide that clearly recommend indicators for the early diagnosis of sepsis in the emergency department. Simple and unified joint diagnostic criteria are also scarce. We compare the Quick Sequential Organ Failure Assessment (qSOFA) score and inflammatory mediator concen-trations in patients with normal infection, sepsis, and sepsis death.Methods: This study used a prospective and consecutive manner, including 79 patients with sepsis in the Emergency Department of Shenzhen People's Hospital from December 2020 to June 2021, and 79 patients with common infections (non-sepsis) matched by age and sex during the same period. The sepsis patients were then divided into a sepsis survival group (n = 67) and a sepsis death group (n = 12) based on whether they survived within 28 days. The baseline characteristics, qSOFA scores, the concentrations of tumor necrosis factor-alpha(TNF-alpha), interleukin (IL)-6, IL-1b, IL-8, IL-10, procalcitonin (PCT), high-sensitivity C-reactive protein (HSCRP) and other indicators were collected in all subjects.Results: PCT and qSOFA were independent risk factors for predicting sepsis in the emergency department. The AUC value of PCT was the largest (0.819) among all diagnostic indicators of sepsis, with a cut-off value of 0.775 ng/ml and sensitivity and specificity of 0.785 and 0.709, respectively. The AUC of qSOFA combined PCT was the largest (0.842) in the combination of the 2 indicators, and the sensitivity and specificity were 0.722 and 0.848, respectively. IL-6 was an independent risk factor for predicting death within 28 days. IL-8 had the largest AUC value (0.826) among all indicators predicting sepsis death, with a cut-off value of 215 pg/ml and sensitivity and specificity of 0.667 and 0.895, respectively. Among the combination of two indicators, qSOFA combined with IL -8 had the largest AUC value (0.782) and sensitivity and specificity of 0.833 and 0.612, respectively.Conclusions: QSOFA and PCT are independent risk factors for sepsis, and qSOFA combined with PCT may be an ideal combination for early diagnosis of sepsis in the emergency department. IL-6 is an independent risk factor for death within 28 days of sepsis, and qSOFA combined with IL-8 may be an ideal combination for early pre-diction of death within 28 days in sepsis patients in the emergency department.

Sepsis Emergency department Quick Sequential Organ Failure Assessment (qSOFA) Interleukin-6 Interleukin-8 Clinical chemistry

SCI

英语

通讯

Joint Foundation Established by Enterprises and the Basic and Applied Basic Research Foundation of Guangdong Province, China[2022A1515220169] ; Natural Science Foundation of Guangdong Province, China[2020A151501040] ; Natural Science Foundation of China[81300012] ; Appropriate Health Technology Promotion Project of Guangdong Province[202006181142034974] ; Scientific Research and Cultivation Project of Shenzhen People's Hospital[SYKYPY201912]

Medical Laboratory Technology

Medical Laboratory Technology

WOS:000984660400001

ELSEVIER

CLINICAL MEDICINE

Web of Science

1.Jinan Univ, Clin Med Coll 2, Shenzhen 518020, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Jinan Univ, Affiliated Hosp 1, Dept Infect Dis,Shenzhen Peoples Hosp,Clin Med Col, Shenzhen 518020, Guangdong, Peoples R China
3.Southern Univ Sci & Technol, Jinan Univ, Affiliated Hosp 1, Key Lab Shenzhen Resp Dis,Inst Shenzhen Resp Dis,S, Shenzhen 518020, Guangdong, Peoples R China
4.Shantou Univ, Med Coll, Shantou 515041, Guangdong, Peoples R China

Ling, Huaxiang,Chen, Manqin,Dai, JunJie,et al. Evaluation of qSOFA combined with inflammatory mediators for diagnosing sepsis and predicting mortality among emergency department[J]. CLINICA CHIMICA ACTA,2023,544.

Ling, Huaxiang,Chen, Manqin,Dai, JunJie,Zhong, Haimei,Chen, Rongchang,&Shi, Fei.(2023).Evaluation of qSOFA combined with inflammatory mediators for diagnosing sepsis and predicting mortality among emergency department.CLINICA CHIMICA ACTA,544.

Ling, Huaxiang,et al."Evaluation of qSOFA combined with inflammatory mediators for diagnosing sepsis and predicting mortality among emergency department".CLINICA CHIMICA ACTA 544(2023).