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Article

NEWS2 Is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department

1
Department of Clinical Sciences, Division of Infection Medicine, Lund University, 221 00 Lund, Sweden
2
Department of Infectious Diseases, Skåne University Hospital, 22242 Lund, Sweden
3
Department of Infectious Diseases, Helsingborg General Hospital, 25437 Helsingborg, Sweden
4
Centre for Heart Lung Innovation, Division of Critical Care Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada
5
Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
6
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, 4031 Basel, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1128; https://doi.org/10.3390/jcm8081128
Received: 17 June 2019 / Revised: 18 July 2019 / Accepted: 26 July 2019 / Published: 29 July 2019
Early administration of antibiotics is associated with better survival in sepsis, thus screening and early detection for sepsis is of clinical importance. Current risk stratification scores used for bedside detection of sepsis, for example Quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2), are primarily validated for death and intensive care. The primary aim of this study was to compare the diagnostic accuracy of qSOFA and NEWS2 for a composite outcome of sepsis with organ dysfunction, infection-related mortality within <72 h, or intensive care due to an infection. Retrospective analysis of data from two prospective, observational, multicentre, convenience trials of sepsis biomarkers at emergency departments were performed. Cohort A consisted of 526 patients with a diagnosed infection, 288 with the composite outcome. Cohort B consisted of 645 patients, of whom 269 had a diagnosed infection and 191 experienced the composite outcome. In Cohort A and B, NEWS2 had significantly higher area under receiver operating characteristic curve (AUC), 0.80 (95% CI 0.75–0.83) and 0.70 (95% CI 0.65–0.74), than qSOFA, AUC 0.70 (95% CI 0.66–0.75) and 0.62 (95% CI 0.57–0.67) p < 0.01 and, p = 0.02, respectively for the composite outcome. NEWS2 was superior to qSOFA for screening for sepsis with organ dysfunction, infection-related mortality or intensive care due to an infection both among infected patients and among undifferentiated patients at emergency departments. View Full-Text
Keywords: qSOFA; early warning score; NEWS2; sepsis; validation studies qSOFA; early warning score; NEWS2; sepsis; validation studies
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MDPI and ACS Style

Mellhammar, L.; Linder, A.; Tverring, J.; Christensson, B.; Boyd, J.H.; Sendi, P.; Åkesson, P.; Kahn, F. NEWS2 Is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department. J. Clin. Med. 2019, 8, 1128. https://doi.org/10.3390/jcm8081128

AMA Style

Mellhammar L, Linder A, Tverring J, Christensson B, Boyd JH, Sendi P, Åkesson P, Kahn F. NEWS2 Is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department. Journal of Clinical Medicine. 2019; 8(8):1128. https://doi.org/10.3390/jcm8081128

Chicago/Turabian Style

Mellhammar, Lisa, Adam Linder, Jonas Tverring, Bertil Christensson, John H. Boyd, Parham Sendi, Per Åkesson, and Fredrik Kahn. 2019. "NEWS2 Is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department" Journal of Clinical Medicine 8, no. 8: 1128. https://doi.org/10.3390/jcm8081128

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