ArticleBMJ open2021
Comparison of SIRS criteria and qSOFA score for identifying culture-positive sepsis in the emergency department: a prospective cross-sectional multicentre study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Sepsis in Italian departments of internal medicine: an increasing challenge.Internal and emergency medicine · 2026Article
- Peripheral Blood Mononuclear Cells in Sepsis: Immune Trajectories, Monocyte Dysfunction, and Translational Biomarkers.Journal of inflammation research · 2026Review
- Article
- Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction.Internal and emergency medicine · 2023Article
- Classifying sepsis from photoplethysmography.Health information science and systems · 2022Article
- Predictive Value of Systemic Immune-inflammation Index in Determining Mortality in COVID-19 Patients.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2022Article
- Retrospective Analysis of the Risk Factors and Drug Resistance of Pathogenic Bacteria in Systemic Inflammatory Response Syndrome After Ureteroscopic Holmium Laser Lithotripsy for Impacted Ureteral Calculi.International journal of general medicine · 2022Article
- Comparison of QSOFA and sirs scores for the prediction of adverse outcomes of secondary peritonitis among patients admitted on the adult surgical ward in a tertiary teaching hospital in Uganda: a prospective cohort study.BMC emergency medicine · 2021Article
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9 authors.
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Abstract
objectiveTo compare the daily practice of two emergency departments (ED) in the Netherlands, where systemic inflammatory response syndrome (SIRS) criteria and quick Sequential Organ Failure Assessment (qSOFA) score are used differently as screening tools for culture-positive sepsis.
designA prospective cross-sectional multicentre study.
settingTwo EDs at two European clinical teaching hospitals in the Netherlands.
participants760 patients with suspected infection who met SIRS criteria or had a qualifying qSOFA score who were treated at two EDs in the Netherlands from 1 January to 1 March 2018 were included.
methodsSIRS criteria and qSOFA score were calculated for each patient. The first hospital treated the patients who met SIRS criteria following the worldwide Surviving Sepsis Campaign protocol. At the second hospital, only patients who met the qualifying qSOFA score received this treatment. Therefore, patients could be divided into five groups: (1) SIRS+, qSOFA-, not treated according to protocol (reference group); (2) SIRS+, qSOFA-, treated according to protocol; (3) SIRS+, qSOFA+, treated according to protocol; (4) SIRS-, qSOFA+, not treated according to protocol; (5) SIRS-, qSOFA+, treated according to protocol. PRIMARY AND SECONDARY OUTCOME MEASURES: To prove culture-positive sepsis was present, cultures were used as the primary outcome. Secondary outcomes were in-hospital mortality and intensive care unit (ICU) admission.
results98.9% met SIRS criteria and 11.7% met qSOFA score. Positive predictive values of SIRS criteria and qSOFA score were 41.2% (95% CI 37.4% to 45.2%) and 48.1% (95% CI 37.4% to 58.9%), respectively. HRs were 0.79 (95% CI 0.40 to 1.56, p=0.500), 3.42 (95% CI 1.82 to 6.44, p<0.001), 18.94 (95% CI 2.48 to 144.89, p=0.005) and 4.97 (95% CI 1.44 to 17.16, p=0.011) for groups 2-5, respectively.
conclusionqSOFA score performed as well as SIRS criteria for identifying culture-positive sepsis and performed significantly better for predicting in-hospital mortality and ICU admission. This study shows that SIRS criteria are no longer necessary and recommends qSOFA score as the standard for identifying culture-positive sepsis in the ED. TRIAL REGISTRATION NUMBER: NL8315.
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