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NEWS2 is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department

Mellhammar, Lisa LU ; Linder, Adam LU ; Tverring, Jonas LU ; Christensson, Bertil LU ; Boyd, John H; Sendi, Parham; Åkesson, Per LU and Kahn, Fredrik LU (2019) In Journal of Clinical Medicine 8(8).
Abstract

Early administration of antibiotics is associated with better survival in sepsis, thus screening and early detection for sepsis is of clinical importance. Current risk stratification scores used for bedside detection of sepsis, for example Quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2), are primarily validated for death and intensive care. The primary aim of this study was to compare the diagnostic accuracy of qSOFA and NEWS2 for a composite outcome of sepsis with organ dysfunction, infection-related mortality within <72 h, or intensive care due to an infection. Retrospective analysis of data from two prospective, observational, multicentre, convenience trials of sepsis biomarkers at... (More)

Early administration of antibiotics is associated with better survival in sepsis, thus screening and early detection for sepsis is of clinical importance. Current risk stratification scores used for bedside detection of sepsis, for example Quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2), are primarily validated for death and intensive care. The primary aim of this study was to compare the diagnostic accuracy of qSOFA and NEWS2 for a composite outcome of sepsis with organ dysfunction, infection-related mortality within <72 h, or intensive care due to an infection. Retrospective analysis of data from two prospective, observational, multicentre, convenience trials of sepsis biomarkers at emergency departments were performed. Cohort A consisted of 526 patients with a diagnosed infection, 288 with the composite outcome. Cohort B consisted of 645 patients, of whom 269 had a diagnosed infection and 191 experienced the composite outcome. In Cohort A and B, NEWS2 had significantly higher area under receiver operating characteristic curve (AUC), 0.80 (95% CI 0.75-0.83) and 0.70 (95% CI 0.65-0.74), than qSOFA, AUC 0.70 (95% CI 0.66-0.75) and 0.62 (95% CI 0.57-0.67) p < 0.01 and, p = 0.02, respectively for the composite outcome. NEWS2 was superior to qSOFA for screening for sepsis with organ dysfunction, infection-related mortality or intensive care due to an infection both among infected patients and among undifferentiated patients at emergency departments.

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in
Journal of Clinical Medicine
volume
8
issue
8
ISSN
2077-0383
DOI
10.3390/jcm8081128
language
English
LU publication?
yes
id
20783b8f-75ff-435f-b4e5-1769578679a9
date added to LUP
2019-08-20 15:14:39
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2019-08-20 15:42:25
@article{20783b8f-75ff-435f-b4e5-1769578679a9,
  abstract     = {<p>Early administration of antibiotics is associated with better survival in sepsis, thus screening and early detection for sepsis is of clinical importance. Current risk stratification scores used for bedside detection of sepsis, for example Quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2), are primarily validated for death and intensive care. The primary aim of this study was to compare the diagnostic accuracy of qSOFA and NEWS2 for a composite outcome of sepsis with organ dysfunction, infection-related mortality within &lt;72 h, or intensive care due to an infection. Retrospective analysis of data from two prospective, observational, multicentre, convenience trials of sepsis biomarkers at emergency departments were performed. Cohort A consisted of 526 patients with a diagnosed infection, 288 with the composite outcome. Cohort B consisted of 645 patients, of whom 269 had a diagnosed infection and 191 experienced the composite outcome. In Cohort A and B, NEWS2 had significantly higher area under receiver operating characteristic curve (AUC), 0.80 (95% CI 0.75-0.83) and 0.70 (95% CI 0.65-0.74), than qSOFA, AUC 0.70 (95% CI 0.66-0.75) and 0.62 (95% CI 0.57-0.67) p &lt; 0.01 and, p = 0.02, respectively for the composite outcome. NEWS2 was superior to qSOFA for screening for sepsis with organ dysfunction, infection-related mortality or intensive care due to an infection both among infected patients and among undifferentiated patients at emergency departments.</p>},
  author       = {Mellhammar, Lisa and Linder, Adam and Tverring, Jonas and Christensson, Bertil and Boyd, John H and Sendi, Parham and Åkesson, Per and Kahn, Fredrik},
  issn         = {2077-0383},
  language     = {eng},
  month        = {07},
  number       = {8},
  series       = {Journal of Clinical Medicine},
  title        = {NEWS2 is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department},
  url          = {http://dx.doi.org/10.3390/jcm8081128},
  volume       = {8},
  year         = {2019},
}