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The role of qSOFA compared to other prognostic scores in septic patients upon admission to the emergency department

      Sepsis is a life-threatening, high-mortality syndrome that is still lacking a validated standard diagnostic test, although it is widely recognised that early identification of these conditions is a key factor for improving prognosis. Sepsis and septic shock are both underdiagnosed and undertreated [
      • Deis A.S.
      • Whiles B.B.
      • Brown A.R.
      • Satterwhite C.L.
      • Simpson S.Q.
      Three-hour bundle compliance and outcomes in patients with undiagnosed severe sepsis.
      ]. In order to quickly identify septic patients at higher risk of negative outcomes, several scores have been proposed as valuable screening tools such as SIRS (Systemic Inflammatory Response Syndrome) [
      • Alberti C.
      • Brun-Buisson C.
      • Goodman S.V.
      • Guidici D.
      • Granton J.
      • Moreno R.
      • et al.
      Influence of systemic inflammatory response syndrome and sepsis on outcome of critically ill infected patients.
      ], modified Early Warning Score (MEWS) score [
      • Subbe C.P.
      • Kruger M.
      • Rutherford P.
      • Gemmel L.
      Validation of a modified early warning score in medical admissions.
      ] and the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score [
      • Vincent J.L.
      • Moreno R.
      • Takala J.
      • Willatts S.
      • De Mendonça A.
      • Bruining H.
      • et al.
      The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on Sepsis-related problems of the European Society of Intensive Care Medicine.
      ]. Recently, the quick SOFA (qSOFA) score was proposed as to identify septic patients who have higher risk of negative outcomes [
      • Seymour C.W.
      • Liu V.X.
      • Iwashyna T.J.
      • Brunkhorst F.M.
      • Rea T.D.
      • Scherag A.
      • et al.
      Assessment of clinical criteria for Sepsis: for the third international consensus definitions for Sepsis and septic shock (Sepsis-3).
      ]. The advantage of the qSOFA score is being based on three parameter evaluation (respiratory rate, mental status and blood pressure), without the need of laboratory tests. Aim of the present study was to evaluate the predictivity of qSOFA compared with other prognostic scores (SIRS criteria, MEWS score and SOFA score) of in-hospital mortality and ICU admission in consecutive patients admitted to the local Emergency Department (ED). The correlation between the BCs results and prognostic scores was also analyzed.

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