Sensitivity and Specificity of a quick Sequential [Sepsis-Related] Organ Failure Assessment Sepsis Screening Tool
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Marshall, Andrea P
Walker, Rachel M
Pálizas, Fernando
Aitken, Leanne M
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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.
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International Journal of Clinical Practice
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© 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Sensitivity and specificity of a quick sequential [Sepsis-Related] organ failure assessment sepsis screening tool, Advanced Energy Materials, 2021, 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 Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
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Clinical sciences
Public health
developing nation
hospital ward
qSOFA
screening
sensitivity
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Alberto, L; Marshall, AP; Walker, RM; Pálizas, F; Aitken, LM, Sensitivity and Specificity of a quick Sequential [Sepsis-Related] Organ Failure Assessment Sepsis Screening Tool, International Journal of Clinical Practice, 2021, pp. e14874