Observational studyChest2017
Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection.
Observational study in Chest, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
124 citing papers in PubMed, 12 syntheses or guidelines pooled it, 299 citations in OpenAlex.
- Platelet parameters as potential biomarkers for sepsis: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Pooled it
- The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis.Critical care (London, England) · 2022Pooled it
- A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis.PloS one · 2022Pooled it
- Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: a meta-analysis.BMC infectious diseases · 2021Pooled it
- Perforated and bleeding peptic ulcer: WSES guidelines.World journal of emergency surgery : WJES · 2020Guideline
- Quick Sequential Organ Failure Assessment as a prognostic factor for infected patients outside the intensive care unit: a systematic review and meta-analysis.Internal and emergency medicine · 2019Pooled it
- SIRS or qSOFA? Is that the question? Clinical and methodological observations from a meta-analysis and critical review on the prognostication of patients with suspected sepsis outside the ICU.Internal and emergency medicine · 2019Pooled it
- Comparison of Prognostic Accuracy of the quick Sepsis-Related Organ Failure Assessment between Short- & Long-term Mortality in Patients Presenting Outside of the Intensive Care Unit - A Systematic Review & Meta-analysis.Scientific reports · 2018Pooled it
- Head-to-head comparison of qSOFA and SIRS criteria in predicting the mortality of infected patients in the emergency department: a meta-analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Pooled it
- Performance of the quick Sequential (sepsis-related) Organ Failure Assessment score as a prognostic tool in infected patients outside the intensive care unit: a systematic review and meta-analysis.Critical care (London, England) · 2018Pooled it
- Prevalence and prognosis of acutely ill patients with organ failure at arrival to hospital: A systematic review.PloS one · 2018Pooled it
- Quick sequential organ failure assessment versus systemic inflammatory response syndrome criteria for emergency department patients with suspected infection.Scientific reports · 2021Trial
- Characteristics associated with culture-positivity versus antibiotic administration in patients with cirrhosis on ICU admission: a retrospective cohort study in 5 hospitals.medRxiv : the preprint server for health sciences · 2026Article
- Evaluation of the clinical characteristics and risk factors for in-hospital mortality amongst older persons admitted with bacteraemia in a geriatric ward - a single tertiary centre review.BMC geriatrics · 2026Article
- Beyond bacteremia: clinical phenotypes and determinants of mortality in hospitalized adults with community-acquired urinary tract infection.Frontiers in medicine · 2026Article
- MIDAS: rapid, multiplexed molecular profiling for integrated host-pathogen analysis.Nature communications · 2025Article
- To evaluate the effectiveness and usefulness of qSOFA scoring in predicting mortality in acute pancreatitis - A teaching institute study.Journal of family medicine and primary care · 2025Article
- Reformulating patient stratification for targeting interventions by accounting for severity of downstream outcomes resulting from disease onset: a case study in sepsis.Journal of the American Medical Informatics Association : JAMIA · 2025Observational
- A framework and analytical exploration for a data-driven update of the Sequential Organ Failure Assessment (SOFA) score in sepsis.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Article
64 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA proposed revision of sepsis definitions has abandoned the systemic inflammatory response syndrome (SIRS), defined organ dysfunction as an increase in total Sequential Organ Function Assessment (SOFA) score of ≥ 2, and conceived "qSOFA" (quick SOFA) as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare the diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in ED patients with infection.
methodsConsecutive ED patients admitted with presumed infection were prospectively enrolled over 3 years. Sufficient observational data were collected to calculate SIRS, qSOFA, SOFA, comorbidity, and mortality.
resultsWe enrolled 8,871 patients, with SIRS present in 4,176 (47.1%). SIRS was associated with increased risk of organ dysfunction (relative risk [RR] 3.5) and mortality in patients without organ dysfunction (OR 3.2). SIRS and qSOFA showed similar discrimination for organ dysfunction (area under the receiver operating characteristic curve, 0.72 vs 0.73). qSOFA was specific but poorly sensitive for organ dysfunction (96.1% and 29.7%, respectively). Mortality for patients with organ dysfunction was similar for Sepsis-2 and Sepsis-3 (12.5% and 11.4%, respectively), although 29% of patients with Sepsis-3 organ dysfunction did not meet Sepsis-2 criteria. Increasing numbers of Sepsis-2 organ system dysfunctions were associated with greater mortality.
conclusionsSIRS was associated with organ dysfunction and mortality, and abandoning the concept appears premature. A qSOFA score ≥ 2 showed high specificity, but poor sensitivity may limit utility as a bedside screening method. Although mortality for organ dysfunction was comparable between Sepsis-2 and Sepsis-3, more prognostic and clinical information is conveyed using Sepsis-2 regarding number and type of organ dysfunctions. The SOFA score may require recalibration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.