Mortality and detailed characteristics of pre-ICU qSOFA-negative patients with suspected sepsis: an observational study

Nakayama, Izumi; Izawa, Junichi; Mouri, Hideyuki et al.

Annals of Intensive Care, 2018, 8, 44

Number of Access:691（2025-10-23 01:22 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78391

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Title
Mortality and detailed characteristics of pre-ICU qSOFA-negative patients with suspected sepsis: an observational study
Creator
CreatorName
Nakayama, Izumi
CreatorName
Izawa, Junichi
CreatorName
Mouri, Hideyuki
NRID
1000030639810 1000030639810
ORCID
0000-0003-0107-0580 0000-0003-0107-0580
researchmap permalink
Kitamura_T Kitamura_T
Scopus Author ID
22234282700 22234282700
CreatorName
Kitamura, Tetsuhisa
CreatorName
Shiotsuka, Junji
Subject
Bacteremia
Critical care
Infection
Intensive care unit
Mortality
quick Sequential Organ Failure Assessment (qSOFA) score
Sepsis
Description
Nakayama, I., Izawa, J., Mouri, H. et al. Mortality and detailed characteristics of pre-ICU qSOFA-negative patients with suspected sepsis: an observational study. Ann. Intensive Care 8, 44 (2018). https://doi.org/10.1186/s13613-018-0389-3
Abstract
Background: Recent studies have suggested that quick Sequential Organ Failure Assessment (qSOFA) scores have limited utility in early prognostication in high-mortality populations. The purpose of this study was to investigate the association between pre-ICU qSOFA scores and in-hospital mortality among patients admitted to the ICU with suspected sepsis. This study also aimed to describe detailed clinical characteristics of qSOFA-negative (< 2) patients. Methods: This single center, observational study, conducted in a Japanese tertiary care teaching hospital between May 2012 and June 2016, enrolled all consecutive adult patients admitted to the ICU with suspected sepsis. We assessed pre-ICU qSOFA scores with the most abnormal vital signs during the 24-h period before ICU admission. The primary outcome was in-hospital mortality censored at 90 days. We analyzed the association between pre-ICU qSOFA scores and in-hospital mortality. Results: Among 185 ICU patients with suspected sepsis, 14.1% (26/185) of patients remained qSOFA-negative at the time of ICU admission and 29.2% (54/185) of patients died while in hospital. In-hospital mortality was similar between the groups (qSOFA-positive [≥ 2]: 30.2% [48/159] vs qSOFA-negative: 23.1% [6/26], p = 0.642). The Cox proportional hazard regression model revealed that being qSOFA-positive was not significantly associated with in-hospital mortality (adjusted hazard ratio 1.35, 95% confidence interval 0.56-3.22, p = 0.506). Bloodstream infection, immunosuppression, and hematologic malignancy were observed more frequently in qSOFA-negative patients. Conclusions: Among ICU patients with suspected sepsis, we could not find a strong association between pre-ICU qSOFA scores and in-hospital mortality. Our study suggested high mortality and bacterial diversity in pre-ICU qSOFA-negative patients.
Publisher
Springer Verlag
Source Title
Annals of Intensive Care
Volume (Issue)
8
Page
44
Date of Issued
2018-04-03
Language
English
Handle URL
https://hdl.handle.net/11094/78391
eISSN
21105820
Relation.isIdenticalTo
DOI (Publisher Version)
https://doi.org/10.1186/s13613-018-0389-3
Access Rights
open access
CopyRight
© 2018 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version
Version of Record
Category
学術雑誌論文 Journal Article