qSOFA or SIRS - The Better Predictor of Bacterial Sepsis in the Emergency Room

BACKGROUND: Sepsis is a major cause of Emergency Medicine Department admissions and is associated with high morbidity and mortality.2Early identification is of prime importance in the management of the same. The Sepsis -3 taskforce introduced the qSOFA (quick Sepsis related organ failure assessment) to identify patients in sepsis outside the ICU. However the novel SIRS criteria even though non specific helps to identify patients in sepsis. OBJECTIVE: The main objective of this study was to validate the efficiency of qSOFA in comparison with SIRS criteria to diagnose bacterial sepsis using Procalcitonin as a marker of sepsis. Another objective was to find the association of qSOFA with mortality at 28 days. METHODS: The study is a Prospective Cross Sectional Validation study was carried out among patients admitted to the Emergency Room at a tertiary care hospital. The efficacy of qSOFA and SIRS is compared to procalcitonin which in this study is taken as a marker of bacterial sepsis. Also the association of qSOFA with 28 day mortality is also found. RESULTS: A total of 128 consecutive patients who fulfilled the inclusion criteria were included in the study.59.5 % of patients positive for SIRS criteria had Procalcitonin greater than1ng /dL, and this was statistically significant (p value 1ng/dL, and this was statistically significant (p value =0.102) when compared to qSOFA negative cases. This association had a sensitivity of 33.3 %, specificity of 80 % and an accuracy of 51.5 %.63.9 % of patients with a positive qSOFA criteria had expired by the end of 28 days, which showed statistical significance when compared to the qSOFA negative group (p value