The evaluation of sepsis in the emergency department and its association with mortality

Abstract

Aim: Sepsis is a life-threatening organ dysfunction accompanied by a dysregulated host response to infection. Patients with sepsis may present with different clinical manifestations, and there is no gold standard diagnostic test. Early diagnosis and rapid treatment result in a decrease in sepsis-related deaths. Quick Sequential Organ Failure Assessment (qSOFA) is a scoring system used in diagnosing sepsis through a rapid evaluation at the time of initial presentation. The purpose of this study was to evaluate the relationship between qSOFA scores and mortality in patients presenting to the emergency department with suspected sepsis. Material and Method: Seventy patients presenting to the Atatürk University Medical Faculty Emergency Department and commencing treatment with a preliminary diagnosis of sepsis between 01.12.2019 and 01.06.2020 were included in the research. Patients’ qSOFA scores were calculated, and their demographic data, infection parameters and foci, the clinics to which they were admitted, and outcomes were recorded. The data were analyzed, and the relationships between qSOFA classifications and other infection parameters (CRP, procalcitonin, and lactate) and mortality were examined. Results: Seventy percent (n=49) of the 70 patients in the study were discharged, while 30% (n=21) were exitus. A statistically significant relationship was present between qSOFA scores and mortality (p<0.001). CRP was also significantly related to qSOFA (p=0.003). Significant relationships were determined between CRP, procalcitonin and lactate and mortality (p=0.009, p<0.001, and p=0.009, respectively). Conclusion: The use of qSOFA scores at initial assessment in the emergency department appears to be a simple and rapid means of diagnosing sepsis. qSOFA levels were significantly associated with mortality. CRP, procalcitonin, and lactate levels were also associated with mortality, and CRP was significantly associated with qSOFA. Early diagnosis and treatment can be expected to reduce mortality

Keywords

• Sepsis
• qSOFA
• Emergency
• Mortality

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