Evidence map›Paper›PMID 34742255›Full record

ArticleBMC emergency medicine2021

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.

Emmanuel Nkonge, Olivia Kituuka, William Ocen, Herbert Ariaka, Alfred Ogwal, Badru Ssekitoleko

Open access · goldAbstract read
In one paragraph

Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Systemic Inflammation after Aneurysmal Subarachnoid Hemorrhage.International journal of molecular sciences · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Emmanuel NkongeDepartment of Surgery, Villa Maria Hospital, P.O Box 32, Masaka, Uganda.
Olivia KituukaDepartment of Surgery, Makerere University, College of Health Sciences, P. O. Box 7072, Kampala, Uganda. okituuka@gmail.com.
William OcenDepartment of Surgery, Lira University, P.O. Box 1035, Lira, Uganda.
Herbert AriakaDepartment of Surgery, Uganda Heart Institute, Kampala, Uganda.
Alfred OgwalDepartment of Surgery, Maridi County Hospital, Maridi, Western Equatoria State, South Sudan.
Badru SsekitolekoDepartment of Surgery, Makerere University, College of Health Sciences, P. O. Box 7072, Kampala, Uganda.
Makerere University · UGLira Hospital · UGUganda Management Institute · UGVilla Maria Hospital · UG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSIRS and qSOFA are two ancillary scoring tools that have been used globally, inside and outside of ICU to predict adverse outcomes of infections such as secondary peritonitis. A tertiary teaching hospital in Uganda uses SIRS outside the ICU to identify patients with secondary peritonitis, who are at risk of adverse outcomes. However, there are associated delays in decision making given SIRS partial reliance on laboratory parameters which are often not quickly available in a resource limited emergency setting. In response to the practical limitations of SIRS, the sepsis-3 task force recommends qSOFA as a better tool. However, its performance in patients with secondary peritonitis in comparison to that of SIRS has not been evaluated in a resource limited setting of a tertiary teaching hospital in a low and middle income country like Uganda.

objectiveTo compare the performance of qSOFA and SIRS scores in predicting adverse outcomes of secondary peritonitis among patients on the adult surgical wards in a tertiary teaching hospital in Uganda.

methodsThis was a prospective cohort study of patients with clinically confirmed secondary peritonitis, from March 2018 to January 2019 at the Accident and Emergency unit and the adult surgical wards of a tertiary teaching hospital in Uganda. QSOFA and SIRS scores were generated for each patient, with a score of ≥2 recorded as high risk, while a score of < 2 recorded as low risk for the adverse outcome respectively. After surgery, patients were followed up until discharge or death. In-hospital mortality and prolonged hospital stay were the primary and secondary adverse outcomes, respectively. Sensitivity, specificity, PPV, NPV and accuracy at 95% confidence interval were calculated for each of the scores using STATA v.13.

resultsA total of 153 patients were enrolled. Of these, 151(M: F, 2.4:1) completed follow up and were analysed, 2 were excluded. Mortality rate was 11.9%. Fourty (26.5%) patients had a prolonged hospital stay. QSOFA predicted in-hospital mortality with AUROC of 0.52 versus 0.62, for SIRS. Similarly, qSOFA predicted prolonged hospital stay with AUROC of 0.54 versus 0.57, for SIRS.

conclusionSIRS is superior to qSOFA in predicting both mortality and prolonged hospital stay among patients with secondary peritonitis. However, overall, both scores showed a poor discrimination for both adverse outcomes and therefore not ideal tools.

Indexed as

PeritonitisSepsisAdultEmergency Service, HospitalHospital MortalityHospitals, TeachingHumansOrgan Dysfunction ScoresPrognosisProspective StudiesRetrospective StudiesSystemic Inflammatory Response SyndromeUgandaAdverse outcomesqSOFASecondary peritonitisSIRS

Identifiers

PMID34742255
PMCPMC8571823
OpenAlexW3212099179

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.