Mortality predictors in patients with suspected sepsis in the emergency department of a tertiary care hospital: a retrospective cohort study

Mortality predictors in patients with suspected sepsis in the emergency department of a tertiary care hospital: a retrospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mortality predictors in patients with suspected sepsis in the emergency department of a tertiary care hospital: a retrospective cohort study João P. M. Bidart, Regis G. Rosa, Marina Bessel, Luana G. Pedrotti, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3853673/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Jun, 2024 Read the published version in International Journal of Emergency Medicine → Version 1 posted 9 You are reading this latest preprint version Abstract Conclusions: Even though an association was found between qSOFA and ICU admission, there was no association of qSOFA or the severity criteria with mortality. Further studies are necessary to assess novel scores or biomarkers to predict mortality in sepsis patients admitted to the emergency department's initial care. Background: Sepsis remains a worldwide major cause of hospitalization, mortality, and morbidity. In order to improve the ability to identify patients with suspected sepsis in a high possibility of mortality and adverse outcomes in the emergency department, mortality predictors are applicable. This study aims to establish whether qSOFA and the severity criteria applied in patients with suspicion of sepsis in a monitored emergency department (ED) are in fact predictors of mortality. We performed a retrospective cohort study among adult patients with suspicion of sepsis at the emergency department of a tertiary care hospital in Brazil between January 1 st , 2019 and December 31, 2020. All adult patients (age ≥18 yr) with suspected sepsis that scored two or more points on qSOFA score or at least one point on the severity criteria score were included in the study. Results: The total of patients included in the study was 665 and the average age of the sample was 73 + 19 years.The proportion between male and female subjects was similar. Most patients exhibited qSOFA ≥ 2 (58.80%) and 356 patients (53.61%) scored one point in the severity criteria at admission. Overall mortality was 19.7% (131 patients). 98 patients (14.74%) exhibited positive blood cultures, with the most isolated bacteria being Escherichia coli . Neither scores of qSOFA nor the severity criteria were associated with mortality rates, but scoring any point on qSOFA was considered as an independent factor for ICU admission (qSOFA=1 point, p=0.02; qSOFA=2 points, p=0.03, and qSOFA= 3 points, p=0.04). Positive blood cultures (RR, 1.63;95% CI, 1.10 to 2.41) and general administration of vasopressors at the emergency department (RR, 2.14;95% CI, 1.44 to 3.17) were associated with 30-day mortality. The administration of vasopressors at the emergency room (RR, 2.25; CI 95%, 1.58 to 3.21) was found to be a predictor of overall mortality. emergency department sepsis septicemia quick sofa intensive care unit Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 16 Jun, 2024 Read the published version in International Journal of Emergency Medicine → Version 1 posted Editorial decision: Revision requested 29 Apr, 2024 Reviews received at journal 29 Apr, 2024 Reviews received at journal 24 Mar, 2024 Reviewers agreed at journal 22 Mar, 2024 Reviewers agreed at journal 19 Mar, 2024 Reviewers invited by journal 22 Feb, 2024 Submission checks completed at journal 29 Jan, 2024 Editor assigned by journal 29 Jan, 2024 First submitted to journal 11 Jan, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3853673","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":269872459,"identity":"39fd616a-c02e-40b2-8927-264ef2ce15d4","order_by":0,"name":"João P. M. Bidart","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8ElEQVRIiWNgGAWjYBACxgYwdYCH4QCQ+gDEbOwkaGFsnAHSwkycZQdAiLGZB8QmpIW5vfnh4wKGOzJ8x88+f2zza5s8HzMD44ePOXgc1nPM2HgGwzMeyTPphs25fbcN25gZmCVnbsOjZUaCmTQPw2EegwNpjM25PbcZgVrYmHnxakn/BtFy/hljs2XPbXsitORAbbkBtIXhx+1Ewlp6zhQbzzAA+uXGM8aZvQ23k9uYGZvx+sWwvX3j44KKO/Z859MYPvz4c9t2fnvzwQ8f8WlpAEWEAczONjDZgFs9EMgzoMTdH7yKR8EoGAWjYIQCAHJMUgN1eT0UAAAAAElFTkSuQmCC","orcid":"","institution":"Moinhos de Vento Hospital","correspondingAuthor":true,"prefix":"","firstName":"João","middleName":"P. M.","lastName":"Bidart","suffix":""},{"id":269872460,"identity":"c3d8126a-0475-41bc-a341-94d72331ea05","order_by":1,"name":"Regis G. 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Further studies are necessary to assess novel\u0026nbsp;scores or biomarkers to predict mortality in sepsis patients admitted to the emergency department's initial care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eSepsis remains a worldwide major cause of hospitalization, mortality, and morbidity. In order to improve the ability to identify patients with suspected sepsis in a high possibility of mortality and adverse outcomes in the emergency department, mortality predictors are applicable. This study aims to establish whether qSOFA and the severity criteria applied\u0026nbsp;in patients with suspicion of sepsis\u0026nbsp;in a monitored emergency department (ED) are in fact predictors of\u0026nbsp;mortality.\u0026nbsp; We performed a retrospective cohort study among adult patients with suspicion of sepsis at the emergency department of a tertiary care hospital in Brazil between January 1\u003csup\u003est\u003c/sup\u003e, 2019 and December 31, 2020. All adult patients (age ≥18 yr) with suspected sepsis that scored two or more points on qSOFA score or at least one point on the severity criteria score were included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Results:\u003c/strong\u003e The total of patients included in the study was 665 and the average age of the sample was 73 \u003cu\u003e+\u003c/u\u003e 19 years.The proportion between male and female subjects was similar.\u0026nbsp;Most patients exhibited qSOFA ≥ 2 (58.80%) and 356 patients (53.61%) scored one point in the severity criteria at admission. Overall mortality was 19.7% (131 patients). 98 patients (14.74%) exhibited positive blood cultures, with the most isolated bacteria being \u003cem\u003eEscherichia coli\u003c/em\u003e. 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The administration of vasopressors at the emergency room\u0026nbsp;(RR, 2.25; CI 95%, 1.58 to 3.21) was found to be a predictor of overall mortality.\u003c/p\u003e","manuscriptTitle":"Mortality predictors in patients with suspected sepsis in the emergency department of a tertiary care hospital: a retrospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-31 04:18:02","doi":"10.21203/rs.3.rs-3853673/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-04-29T11:12:08+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-29T10:56:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-24T17:35:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98d62113-16fc-4087-9fd9-f282fe8c9ff0","date":"2024-03-22T07:45:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"48b11232-776e-40f2-8b4e-8e00cf8cb7e1","date":"2024-03-19T14:08:34+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-02-22T11:28:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-01-29T12:11:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-01-29T12:11:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Emergency Medicine","date":"2024-01-11T13:45:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijem","sideBox":"Learn more about [International Journal of Emergency Medicine](https://intjem.biomedcentral.com/)","snPcode":"12245","submissionUrl":"https://submission.nature.com/new-submission/12245/3","title":"International Journal of Emergency Medicine","twitterHandle":"@IntJEmergMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5718a420-917f-4d44-b519-76ea77056282","owner":[],"postedDate":"January 31st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-06-17T00:33:52+00:00","versionOfRecord":{"articleIdentity":"rs-3853673","link":"https://doi.org/10.1186/s12245-024-00655-9","journal":{"identity":"international-journal-of-emergency-medicine","isVorOnly":false,"title":"International Journal of Emergency Medicine"},"publishedOn":"2024-06-17 00:33:52","publishedOnDateReadable":"June 17th, 2024"},"versionCreatedAt":"2024-01-31 04:18:02","video":"","vorDoi":"10.1186/s12245-024-00655-9","vorDoiUrl":"https://doi.org/10.1186/s12245-024-00655-9","workflowStages":[]},"version":"v1","identity":"rs-3853673","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3853673","identity":"rs-3853673","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}