Intensive Care Clinical Trial
Official title:
Usefulness of Routine qSOFA Calculation at Triage to Fasten Antimicrobial Administration in Patients With Bacterial Infection in the Emergency Department: a Quasi-experimental Study
The delayed administration of an adequate antimicrobial therapy is a strong predictor of
impaired outcome in patients with bacterial sepsis. Therefore, the current Surviving Sepsis
Campaign guidelines (2016) recommend that administration of intravenous antimicrobials be
initiated within one hour following the recognition of sepsis or septic shock.
The quick Sepsis-related Organ Failure Assessment (qSOFA) score is a new bedside tool which
has been recently proposed by the Third International Sepsis Consensus Definitions Task Force
(Sepsis-3) to identify patients with suspected infection who are at greater risk for a poor
outcome outside the Intensive Care Unit (ICU). It uses three criteria, assigning one point
for low systolic blood pressure (SBP ≤100 mmHg), high respiratory rate (≥22 breaths per min)
and altered mentation (Glasgow coma scale <15). The score ranges from 0 to 3 points. A qSOFA
value ≥2 points is associated with a greater risk of death or prolonged ICU stay, these
outcomes being more common in infected patients who may be septic than in those with
uncomplicated infection. The definite goal of qSOFA is to hasten the management and thus
improve the outcome of patients at risk of sepsis or septic shock.
Many patients admitted to the hospital for bacterial sepsis or septic shock are initially
managed in the Emergency Department (ED). This study aims at investigating whether the
routine calculation of qSOFA at patient triage may hasten the initiation of antimicrobial
therapy in patients admitted to the ED with suspected or proven bacterial infection,
especially in those with subsequent criteria for sepsis or septic shock (Sepsis-3
definition).
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