Fig 1.
Flow diagram of study participants selection for analysis.
Among 10,773 patients who were transported by ambulance to the ED of Hitachi General Hospital from April 2018 to March 2021, we identified 2,407 patients with suspected infection whose prehospital and ED vital signs data were available. Abbreviations: ED, Emergency Department.
Table 1.
The proportion of missing variables in 2,407 patients.
Table 2.
Characteristics of 2,407 patients with suspected infection.
Fig 2.
Receiver-operating-characteristics (ROC) curves of qSOFA among patients with clinically suspected infection.
(A) Prediction of sepsis (B) Prediction of septic shock (C) Prediction of in-hospital mortality. The corresponding values of the area under the receiver operating characteristics curve for each model (i.e., the c-statistics) are presented in Tables 3–5. Abbreviations: ED, Emergency Department; qSOFA, The quick Sequential Organ Failure Assessment.
Fig 3.
Alluvial plot of changes in prehospital and ED qSOFA scores and the diagnosis of sepsis among patients with clinically suspected infection.
This alluvial plot illustrates the changes in qSOFA scores from prehospital to ED arrival and the diagnoses of sepsis based on the Sepsis-3 criteria among patients with clinically suspected infection. As represented by the area in red, combined qSOFA was able to identify 44 (12%) out of 369 patients who were subsequently diagnosed with sepsis based on the Sepsis-3 criteria, which would have been missed using ED qSOFA alone. Abbreviations: ED, Emergency Department; qSOFA, The quick Sequential Organ Failure Assessment.
Table 3.
Predictive abilities of the ED qSOFA, prehospital qSOFA, and combined qSOFA for sepsis.
Table 4.
Predictive abilities of the ED qSOFA, prehospital qSOFA, and combined qSOFA for septic shock.
Table 5.
Predictive abilities of the ED qSOFA, prehospital qSOFA, and combined qSOFA for in-hospital mortality.