Evaluación de ítems de escalas qSOFA y SIRS para predicción de choque séptico en urgencias

Abstract

Introduction

There is no optimal scale to predict sepsis and septic shock, these have different sensitivities and specificities, this can lead to an unnecessary use of resources.

Objective

To evaluate the deterioration times of the variables of the qSOFA and SIRS scales to identify which one changes earlier until presenting septic shock.

Methods

A prospective observational study was conducted. The qSOFA and SIRS items were assessed in adult patients with suspected infectious process who were admitted to the emergency department.

Results

A total of 199 patients, 44.7% (n = 89) developed septic shock. The heart rate criterion, the median time in patients who presented septic shock was 295minutes and those who did not, 354 minutes (P=.211); For respiratory rate, the median time to criterion change in patients with septic shock was 293 minutes and without septic shock 311 minutes (P=.9501); For temperature, no differences were found in the medians of the times. In Glasgow, it was not possible to compare the median times for the change in the criteria. For the patients who presented septic shock, 50% changed the criteria in 313 minutes; For systolic blood pressure, it is evident that in those who did present septic shock, the median was 180 minutes.

Conclusion

No differences were found regarding the change over time of the qSOFA and SIRS variables with a view to predicting septic shock, but we did show delay in antibiotic administration in the septic shock group.