QSOFA SCORE FOR DIAGNOSTICS OF SEPSIS. RESULTS OF THE RUSSIAN MULTI-CENTER TRIAL OF RISES

Abstract

Subjects and methods. The multi-center, prospective, and observational trial was conducted. The following data were analyzed in the patients admitted to intensive care wards: number of qSOFAscores, the presence of SIRS criteria, levels of lactate, procalcitonin, C-reactive protein in blood, the presence of sepsis according to Sepsis-3 criteria. The value of qSOFA scores, SIRS criteria, and biomarkers for sepsis diagnostics was assessed by means of ROC-analysis.Results. The following areas under ROC-curves were defined during diagnostics of sepsis in the patients in intensive care wards: qSOFA – 0.679 (95%CI 0.646–0.712); SIRS – 0.714 (95% CI0.682–0.745), p = 0.099; when qSOFA exceeding 1 score: procalcitonin – 0.788 (95% CI 0.689–0.867), C-reactive protein – 0.787 (95% CI 0.688–0.866), p = 0.970.Conclusion. qSOFA score is compatible with SIRS criteria for diagnostics of sepsis among the patients in intensive care wards. qSOFA score is highly sensitive, but it is of low specificity for sepsis diagnostics. Should there be at least 1 score of qSOFA, it is recommended to test levels of procalcitonin or C-reactive protein in order to increase the specificity of this score for diagnostics of sepsis.

Keywords

• sepsis
• sepsis-3
• diagnostics
• qsofa
• sirs
• lactate
• procalcitonin
• c-reactive protein