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Cited 5 time in webofscience Cited 6 time in scopus
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A quick Sequential Organ Failure Assessment-negative result at triage is associated with low compliance with sepsis bundles: a retrospective analysis of a multicenter prospective registry

Authors
Park, HeesuShin, Tae GunKim, Won YoungJo, You HwanHwang, Yoon JungChoi, Sung-HyukLim, Tae HoHan, Kap SuShin, JonghwanSuh, Gil JoonKang, Gu HyunKim, Kyung SuKorean Shock Society Investigators
Issue Date
Jun-2022
Publisher
대한응급의학회
Keywords
Sepsis; Sequential Organ Failure Assessment score; Compliance
Citation
Clinical and Experimental Emergency Medicine, v.9, no.2, pp 84 - 92
Pages
9
Indexed
SCOPUS
ESCI
KCI
Journal Title
Clinical and Experimental Emergency Medicine
Volume
9
Number
2
Start Page
84
End Page
92
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61301
DOI
10.15441/ceem.22.230
ISSN
2383-4625
Abstract
Objective We investigated the effects of a quick Sequential Organ Failure Assessment (qSOFA)–negative result (qSOFA score <2 points) at triage on the compliance with sepsis bundles among patients with sepsis who presented to the emergency department (ED). Methods Prospective sepsis registry data from 11 urban tertiary hospital EDs between October 2015 and April 2018 were retrospectively reviewed. Patients who met the Third International Consensus Definitions for Sepsis and Septic Shock criteria were included. Primary exposure was defined as a qSOFA score ≥2 points at ED triage. The primary outcome was defined as 3-hour bundle compliance, including lactate measurement, blood culture, broad-spectrum antibiotics administration, and 30 mL/kg crystalloid administration. Multivariate logistic regression analysis to predict 3-hour bundle compliance was performed. Results Among the 2,250 patients enrolled in the registry, 2,087 fulfilled the sepsis criteria. Only 31.4% (656/2,087) of the sepsis patients had qSOFA scores ≥2 points at triage. Patients with qSOFA scores <2 points had lower lactate levels, lower SOFA scores, and a lower 28-day mortality rate. Rates of compliance with lactate measurement (adjusted odds ratio [aOR], 0.47; 95% confidence interval [CI], 0.29–0.75), antibiotics administration (aOR, 0.64; 95% CI, 0.52–0.78), and 30 mL/kg crystalloid administration (aOR, 0.62; 95% CI, 0.49–0.77) within 3 hours from triage were significantly lower in patients with qSOFA scores <2 points. However, the rate of compliance with blood culture within 3 hours from triage (aOR, 1.66; 95% CI, 1.33–2.08) was higher in patients with qSOFA scores <2 points. Conclusion A qSOFA-negative result at ED triage is associated with low compliance with lactate measurement, broad-spectrum antibiotics administration, and 30 mL/kg crystalloid administration within 3 hours in sepsis patients.
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Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
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