ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2020
Screening strategies to identify sepsis in the prehospital setting: a validation study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Screening tools for sepsis identification in paramedicine and other emergency contexts: a rapid systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Pooled it
- Prehospital qSOFA Is Associated with 30-Day Mortality Within Emergency Department Triage Strata in Ambulance-Transported Adults with Suspected Infection: An Exploratory Three-Year Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Knowledge, attitudes, and practices of pre-hospital emergency medical care practitioners regarding sepsis recognition: a cross-sectional study in Qatar.BMC emergency medicine · 2026Article
- Performance Evaluation of Prehospital Sepsis Prediction Models.Critical care medicine · 2025Article
- A comprehensive prognosis model for adult septic shock: SOFAplusCALLY index.European journal of medical research · 2025Article
- Validation and comparison of triage-based screening strategies for sepsis.The American journal of emergency medicine · 2024Article
- The performance of screening tools and use of blood analyses in prehospital identification of sepsis patients and patients suitable for non-conveyance - an observational study.BMC emergency medicine · 2024Observational
- [Sepsis in emergency medical services : A cohort study on screening, incidence, and mortality].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Article
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- Two rare cases of severe community-acquired bloodstream infections: a clinical case report.Frontiers in immunology · 2024Article
- Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department.World journal of emergency medicine · 2024Article
- Prehospital early warning scores for adults with suspected sepsis: retrospective diagnostic cohort study.Emergency medicine journal : EMJ · 2023Article
- Diagnostic Delays in Sepsis: Lessons Learned From a Retrospective Study of Canadian Medico-Legal Claims.Critical care explorations · 2023Article
- Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study.Frontiers in medicine · 2023Article
- Is Prehospital Assessment of qSOFA Parameters Associated with Earlier Targeted Sepsis Therapy? A Retrospective Cohort Study.Journal of clinical medicine · 2022Article
- Prehospital fluid therapy in patients with suspected infection: a survey of ambulance personnel's practice.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Combination of Prehospital NT-proBNP with qSOFA and NEWS to Predict Sepsis and Sepsis-Related Mortality.Disease markers · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the prehospital setting, differentiating patients who have sepsis from those who have infection but no organ dysfunction is important to initiate sepsis treatments appropriately. We aimed to identify which published screening strategies for paramedics to use in identifying patients with sepsis provide the most certainty for prehospital diagnosis.
methodsWe identified published strategies for screening by paramedics through a literature search. We then conducted a validation study in Alberta, Canada, from April 2015 to March 2016. For adult patients (≥ 18 yr) who were transferred by ambulance, we linked records to an administrative database and then restricted the search to patients with infection diagnosed in the emergency department. For each patient, the classification from each strategy was determined and compared with the diagnosis recorded in the emergency department. For all strategies that generated numeric scores, we constructed diagnostic prediction models to estimate the probability of sepsis being diagnosed in the emergency department.
resultsWe identified 21 unique prehospital screening strategies, 14 of which had numeric scores. We linked a total of 131 745 eligible patients to hospital databases. No single strategy had both high sensitivity (overall range 0.02-0.85) and high specificity (overall range 0.38-0.99) for classifying sepsis. However, the Critical Illness Prediction (CIP) score, the National Early Warning Score (NEWS) and the Quick Sepsis-Related Organ Failure Assessment (qSOFA) score predicted a low to high probability of a sepsis diagnosis at different scores. The qSOFA identified patients with a 7% (lowest score) to 87% (highest score) probability of sepsis diagnosis.
interpretationThe CIP, NEWS and qSOFA scores are tools with good predictive ability for sepsis diagnosis in the prehospital setting. The qSOFA score is simple to calculate and may be useful to paramedics in screening patients with possible sepsis.
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