Diagnostic Tools in Sepsis Diagnosis

The Quick Sequential Organ Failure Assessment (qSOFA) criteria are used in patients with suspected infection, but whether they are sensitive enough for use in other patients remains unclear. In this study, researchers evaluated the use of qSOFA criteria in undifferentiated patients. The study included adult patients from 85 U.S. hospitals who met two or more qSOFA criteria within the first day of admission and were evaluated for suspected infection, with clinical cultures and antibiotics, and sepsis, per the Sepsis-3 criteria. Of 1,004,347 patients admitted between 2012 and 2015, 271,500 (27.0%) met at least two qSOFA criteria upon admission. qSOFA-positive patients tended to be older (median age, 65 years) compared to qSOFA-negative patients (median age, 58 years); they were also more likely to be admitted to the intensive care unit (28.5% vs. 6.5%, respectively) and had higher mortality (6.7% vs. 0.8%, respectively) (P < 0.001 for all). qSOFA sensitivity was 41.3% for suspected infection (95% CI, 41.1%-41.5%) and 62.8% for suspected sepsis 62.8% (95% CI, 62.4%-63.1%). Positive predictive values were higher for infection 31.0% (95% CI, 30.8%-31.1%) than sepsis 17.4% (95% CI, 17.2%-17.5%). The authors concluded that qSOFA’s sensitivity was low in suspected cases of infection and sepsis, and stated that tools with higher specificity and sensitivity are needed to screen for and manage risk stratification of sepsis. Read more