Evaluating the diagnostic performance of adult sepsis event criteria in the emergency department: impact of including isolated serum lactate elevations
Authors' conclusion
ASE-defined eSOFA moderately aligns with Sepsis-3 criteria, effectively identifying high-risk ED sepsis cases. Extended eSOFA criteria with lactate enhance sensitivity but reduce specificity
Study context
- Population
- Adults (aged ≥ 19 years) with suspected infections presenting to the emergency department (EDs) of three institutions, September 1 to 30, 2023; blood cultures obtained from all
- Participants
- 251 / 340 / 456
- Comparison
- Adult Sepsis Event (ASE)-defined electronic Sequential Organ Failure Assessment (eSOFA) and extended eSOFA vs Sepsis-3 criteria
- ASE-defined eSOFAn = 251
- Extended eSOFAn = 340
- Sepsis-3n = 456reference
- Outcome
- Diagnostic performance (sensitivity, specificity, PPV, NPV) vs Sepsis-3
Methodological detailsretrospective, multicentre
- Retrospective
- Multicentre
Performance
As reported in the abstract
Diagnostic performance vs Sepsis-3
| Test or model | Sensitivity | Specificity | PPV |
|---|---|---|---|
| ASE-defined eSOFA | 52.0% | 94.2% | 94.4% |
| Extended eSOFA | 64.3% | 80.6% | — not stated in the abstract |
Sensitivity
ASE-defined eSOFA52.0%
Extended eSOFA64.3%
Specificity
ASE-defined eSOFA94.2%
Extended eSOFA80.6%
PPV
ASE-defined eSOFA94.4%
Extended eSOFA— not stated in the abstract
— not stated in the abstract
Further findings
Proportion meeting criteria
Mortality
- Highest among patients classified by both SOFA and eSOFA
- 19.8%
- Mortality increased with the number of dysfunctional organ categories
- Inclusion of isolated lactate elevations identified additional high-risk patients not captured by eSOFA
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Evaluating the diagnostic performance of adult sepsis event criteria in the emergency department: impact of including isolated serum lactate elevations. J Intensive Care. Published 15 August 2025. doi:10.
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