Submitted by Loyola Medicine.
Objective: This study sought to determine the performance characteristics of the sepsis screening tool used in the Emergency Department (ED) at Loyola University Medical Center (LUMC) against qSOFA, in identifying CMS SEP-1 core measure patients.
Methods: This was a retrospective chart review of adult patients who presented to the LUMC ED in May 2017. The test characteristics of the LUMC screening tool and qSOFA were compared against the reference standard established through manual chart review of the medical record and determining the presence of sepsis according to the CMS SEP-1 definitions. The LUMC screening tool performance was evaluated by measuring its sensitivity, specificity, and diagnostic accuracy against qSOFA.
Results: During the study period, 796 patients were reviewed, of which 42 met the CMS SEP-1 definition of sepsis. Our study found the sensitivity and specificity of the LUMC screening tool to be 90.5% and 98.9%, while qSOFA’s was 21.4% and 98.1%, respectively. The LUMC screening tool had a higher accuracy than qSOFA, 98.5% compared to 94.1%.
Conclusion: Our results show that the LUMC screening tool performed significantly better than qSOFA when challenged with real patient data in identifying CMS SEP-1 patients. As early detection is paramount in the management of sepsis and in order to ensure that sepsis is being properly treated and documented in compliance with the CMS SEP-1 core measure, it is important to use the same definitions as the CMS SEP-1 and thus attempt to have a screening tool that is more accurate for this measure.
Read the study from the American Journal of Emergency Medicine.
