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Sensitivity and specificity of a quick sequential [Sepsis-Related] organ failure assessment sepsis screening tool

Alberto, L., Marshall, A. P., Walker, R. M., Pálizas, F. and Aitken, L. M. ORCID: 0000-0001-5722-9090 (2021). Sensitivity and specificity of a quick sequential [Sepsis-Related] organ failure assessment sepsis screening tool. International Journal of Clinical Practice, e14874. doi: 10.1111/ijcp.14874

Abstract

AIM: There is limited evidence on the diagnostic accuracy of a quick Sequential [Sepsis-Related] Organ Failure Assessment (qSOFA) sepsis screening (SS) tool in developing nation health settings. The aim of this study was to test the diagnostic accuracy of a qSOFA-based SS tool, and the predictive validity of the qSOFA score in hospital ward patients from Argentina.

METHODS: Prospective observational study. Patients (≥18 years, without sepsis) were recruited within 24-48 hours of admission to a 169-bed tertiary referral private hospital in Buenos Aires. The index test was the qSOFA-based SS tool, and the reference standard sepsis diagnosed at discharge blindly evaluated with reference to the Sepsis-3.

RESULTS: In 1151 patients (median age 69.9 [IQR, 29.0]); 47 (4.1%) had sepsis, 413 (35.9%) had infection and 691 (60.0%) other diagnoses at discharge. The qSOFA-based SS tool (index test) had moderate sensitivity (60%), good specificity (89%), a very low positive (19%) and very high negative (98%) predictive value for sepsis diagnosed at discharge according to the Sepsis-3 criteria (reference standard). For the same outcome, the qSOFA score in isolation had a reasonable predictive validity area under receiver operating characteristics curve 0.77 (95% CI 0.70-0.83) P < 0.001.

CONCLUSION: The qSOFA score could reasonably discriminate patients at risk of developing sepsis; qSOFA-based screening may be valuable where no screening criteria are in place.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article: Alberto, L., Marshall, A. P., Walker, R. M., Pálizas, F. and Aitken, L. M. (2021). Sensitivity and specificity of a quick sequential [Sepsis-Related] organ failure assessment sepsis screening tool.. International Journal of Clinical Practice, which has been published in final form at https://doi.org/10.1111/ijcp.14874. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords: qSOFA, sensitivity, specificity, sepsis, screening, hospital ward, developing nation
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health Sciences
Date available in CRO: 27 Sep 2021 12:45
Date deposited: 27 September 2021
Date of acceptance: 10 September 2021
Date of first online publication: 16 September 2021
URI: https://openaccess.city.ac.uk/id/eprint/26808
[img] Text - Accepted Version
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