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A quick Sequential Organ Failure Assessment-negative result at triage is associated with low compliance with sepsis bundles: a retrospective analysis of a multicenter prospective registry

Authors
 Heesu Park  ;  Tae Gun Shin  ;  Won Young Kim  ;  You Hwan Jo  ;  Yoon Jung Hwang  ;  Sung-Hyuk Choi  ;  Tae Ho Lim  ;  Kap Su Han  ;  Jonghwan Shin  ;  Gil Joon Suh  ;  Gu Hyun Kang  ;  Kyung Su Kim 
Citation
 CLINICAL AND EXPERIMENTAL EMERGENCY MEDICINE, Vol.9(2) : 84-92, 2022-06 
Journal Title
CLINICAL AND EXPERIMENTAL EMERGENCY MEDICINE
Issue Date
2022-06
Keywords
Compliance ; Sepsis ; Sequential Organ Failure Assessment score
Abstract
Objective: We investigated the effects of a quick Sequential Organ Failure Assessment (qSOFA)-negative result (qSOFA score <2 points) at triage on the compliance with sepsis bundles among patients with sepsis who presented to the emergency department (ED).

Methods: Prospective sepsis registry data from 11 urban tertiary hospital EDs between October 2015 and April 2018 were retrospectively reviewed. Patients who met the Third International Consensus Definitions for Sepsis and Septic Shock criteria were included. Primary exposure was defined as a qSOFA score ≥2 points at ED triage. The primary outcome was defined as 3-hour bundle compliance, including lactate measurement, blood culture, broad-spectrum antibiotics administration, and 30 mL/kg crystalloid administration. Multivariate logistic regression analysis to predict 3-hour bundle compliance was performed.

Results: Among the 2,250 patients enrolled in the registry, 2,087 fulfilled the sepsis criteria. Only 31.4% (656/2,087) of the sepsis patients had qSOFA scores ≥2 points at triage. Patients with qSOFA scores <2 points had lower lactate levels, lower SOFA scores, and a lower 28-day mortality rate. Rates of compliance with lactate measurement (adjusted odds ratio [aOR], 0.47; 95% confidence interval [CI], 0.29-0.75), antibiotics administration (aOR, 0.64; 95% CI, 0.52-0.78), and 30 mL/kg crystalloid administration (aOR, 0.62; 95% CI, 0.49-0.77) within 3 hours from triage were significantly lower in patients with qSOFA scores <2 points. However, the rate of compliance with blood culture within 3 hours from triage (aOR, 1.66; 95% CI, 1.33-2.08) was higher in patients with qSOFA scores <2 points.

Conclusion: A qSOFA-negative result at ED triage is associated with low compliance with lactate measurement, broad-spectrum antibiotics administration, and 30 mL/kg crystalloid administration within 3 hours in sepsis patients.
Files in This Item:
T9992022751.pdf Download
DOI
10.15441/ceem.22.230
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Hwang, Yoon Jung(황윤정) ORCID logo https://orcid.org/0000-0001-7286-7699
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193801
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