ArticleMedicine2018
Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward.
Article in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 35 citations in OpenAlex.
- Clinically recognized sepsis in older adults admitted to medical wards: patient characteristics and hospital outcomes from the REPOSI register.Internal and emergency medicine · 2026Article
- Impact of United Kingdom guidelines for stratification of risk in adult hospital inpatients identified with sepsis - an observational cohort study.BMC infectious diseases · 2026Observational
- The Ability of NEWS2 to Detect Sepsis in Adult Patients With Positive Blood Cultures.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2025Article
- Digital innovation in healthcare: quantifying the impact of digital sepsis screening tools on patient outcomes-a multi-site natural experiment.BMJ health & care informatics · 2025Article
- A Mortality Risk Prediction Model for Septic Shock in Patients Aged ≥50: Role of Norepinephrine Index and Procalcitonin.International journal of general medicine · 2025Article
- Survival prediction for heart failure complicated by sepsis: based on machine learning methods.Frontiers in medicine · 2024Article
- Predictive value of white blood cell to hemoglobin ratio for 30-day mortality in patients with severe intracerebral hemorrhage.Frontiers in neurology · 2023Article
- NEWS2 and improving outcomes from sepsis.Clinical medicine (London, England) · 2022Article
- Association between Mortality and Sequential Organ Failure Assessment Score during a Short Stay in the Intensive Care Unit after Non-Cardiac Surgery.Journal of clinical medicine · 2022Article
- Septic patients without obvious signs of infection at baseline are more likely to die in the ICU.BMC infectious diseases · 2022Observational
- Prediction of prognosis in elderly patients with sepsis based on machine learning (random survival forest).BMC emergency medicine · 2022Article
- The Value of Neutrophil/Lymphocyte Ratio Combined with Red Blood Cell Distribution Width in Evaluating the Prognosis of Emergency Patients with Sepsis.Emergency medicine international · 2022Article
- Sepsis outcomes in patients with pre-existing liver disease.Clinical and experimental hepatology · 2021Article
- The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies.Critical care explorations · 2021Article
- Four consecutive yearly point-prevalence studies in Wales indicate lack of improvement in sepsis care on the wards.Scientific reports · 2021Article
- Diagnostic Accuracy and Prognostic Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Septic Patients outside the Intensive Care Unit.Medicina (Kaunas, Lithuania) · 2021Article
- Review
- SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy.Renal failure · 2020Article
- The Clinical Need for New Diagnostics in the Identification and Management of Patients with Suspected Sepsis in UK NHS Hospitals: A Survey of Healthcare Professionals.Antibiotics (Basel, Switzerland) · 2020Article
- Best diagnostic accuracy of sepsis combining SIRS criteria or qSOFA score with Procalcitonin and Mid-Regional pro-Adrenomedullin outside ICU.Scientific reports · 2020Article
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Authors and funding
37 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Controversy exists regarding the best diagnostic and screening tool for sepsis outside the intensive care unit (ICU). Sequential organ failure assessment (SOFA) score has been shown to be superior to systemic inflammatory response syndrome (SIRS) criteria, however, the performance of "Red Flag sepsis criteria" has not been tested formally.The aim of the study was to investigate the ability of Red Flag sepsis criteria to identify the patients at high risk of sepsis-related death in comparison to SOFA based sepsis criteria. We also investigated the comparison of Red Flag sepsis to quick SOFA (qSOFA), SIRS, and national early warning score (NEWS) scores and factors influencing patient mortality.Patients were recruited into a 24-hour point-prevalence study on the general wards and emergency departments across all Welsh acute hospitals. Inclusion criteria were: clinical suspicion of infection and NEWS 3 or above in-line with established escalation criteria in Wales. Data on Red Flag sepsis and SOFA criteria was collected together with qSOFA and SIRS scores and 90-day mortality.459 patients were recruited over a 24-hour period. 246 were positive for Red Flag sepsis, mortality 33.7% (83/246); 241 for SOFA based sepsis criteria, mortality 39.4% (95/241); 54 for qSOFA, mortality 57.4% (31/54), and 268 for SIRS, mortality 33.6% (90/268). 55 patients were not picked up by any criteria. We found that older age was associated with death with OR (95% CI) of 1.03 (1.02-1.04); higher frailty score 1.24 (1.11-1.40); DNA-CPR order 1.74 (1.14-2.65); ceiling of care 1.55 (1.02-2.33); and SOFA score of 2 and above 1.69 (1.16-2.47).The different clinical tools captured different subsets of the at-risk population, with similar sensitivity. SOFA score 2 or above was independently associated with increased risk of death at 90 days. The sequalae of infection-related organ dysfunction cannot be reliably captured based on routine clinical and physiological parameters alone.
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