Biomarkers Improve Diagnostics of Sepsis in Adult Patients With Suspected Organ Dysfunction Based on the Quick Sepsis-Related Organ Failure Assessment (qSOFA) Score in the Emergency Department*
Authors' conclusion
Biomarkers of infection and organ dysfunction, most notably procalcitonin, substantially improve early prediction of sepsis with added value to qSOFA alone as a simple screening tool on emergency department admission.
Study context
- Population
- Adults presenting to the ED with suspected organ dysfunction (qSOFA ≥1), 3 tertiary EDs at German university hospitals
- Participants
- 1,477 adults
- Exposure
- Biomarkers added to qSOFA vs qSOFA alone
- Outcome
- Prediction of sepsis within 96 hours of admission
- Follow-up
- 96 hours
Methodological detailsmulticentre, diagnostic biomarker study
- Multicentre
- Diagnostic biomarker study
Main finding
As reported in the abstract
Sepsis within 96 hours
| Group | AUC-ROC |
|---|---|
| Procalcitonin | 0.86 [0.79-0.93] |
Procalcitonin
AUC-ROC0.86 [0.79-0.93]
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Procalcitonin | Net (re)classification improvement |
|---|---|---|
| Procalcitonin cutoff 0.25 ng/mL added to qSOFA | 35.2% | |
| PPV | 60.7% | |
| NPV | 88.7% |
Secondary endpoints (mortality, vasopressors, dialysis)
- Other biomarkers improved the model for several secondary endpoints
Sepsis incidence among qSOFA = 1 (81% of cohort)
- Developed sepsis
- 29.2%
Original publication
Biomarkers Improve Diagnostics of Sepsis in Adult Patients With Suspected Organ Dysfunction Based on the Quick Sepsis-Related Organ Failure Assessment (qSOFA) Score in the Emergency Department*. Crit Care Med. Published 7 February 2024. doi:10.
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