TY  - JOUR
VL  - 10
ID  - unic6789
SN  - 2296-858X
Y1  - 2023///
TI  - Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study
AV  - public
UR  - http://doi.org/10.3389/fmed.2023.1149736
JF  - Frontiers in Medicine
KW  - sepsis
KW  -  early warning scores
KW  -  septic shock
KW  -  point-of-care testing
KW  -  mSOFA
KW  -  prehospital
A1  - Melero-Guijarro, Laura
A1  - Sanz-García, Ancor
A1  - Martín-Rodríguez, Francisco
A1  - Lipari, Vivian
A1  - Mazas Pérez-Oleaga, Cristina
A1  - Carvajal-Altamiranda, Stefanía
A1  - Martínez López, Nohora Milena
A1  - Dominguez Azpíroz, Irma
A1  - Castro Villamor, Miguel A.
A1  - Sánchez Soberón, Irene
A1  - López-Izquierdo, Raúl
N2  - Background: Nowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality.

Methods: Prospective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients (n?=?535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used.

Results: The mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841?0.913), 0.761 (95%CI 0.706?0.816), 0.731 (95%CI 0.674?0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA?s AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results.

Conclusion: The use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario.
ER  -