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Evaluating Sepsis Mortality Predictions from the Emergency Department: A Restrospective Cohort Study Comparing qSOFA, the National Early Warning Score, and the International Early Warning Score

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dc.creatorAlfonso Parada, Juan Manuel
dc.creatorDevia Jaramillo, Germán Alberto
dc.creatorErazo Guerrero, Lilia
dc.creatorLaguado Castro, Vivian
dc.date.accessioned2025-08-22T12:30:36Z
dc.date.available2025-08-22T12:30:36Z
dc.date.created2025-07-07
dc.date.issued2025-07-09
dc.descriptionIntroducción: La sepsis tiene una alta tasa de mortalidad, especialmente en países de bajos ingresos. Mejorar los resultados depende del reconocimiento temprano de los pacientes con riesgo de muerte. Por lo tanto, se necesitan puntuaciones de predicción rápidas y aplicables en la clasificación de urgencias. Objetivo: Este estudio evaluó la eficacia de las escalas qSOFA, NEWS e IEWS para predecir la mortalidad hospitalaria durante la clasificación de urgencias. Además, se analizó la eficacia de la escala IEWS_L, que integra la escala IEWS con los niveles de lactato arterial medidos al ingresar en el servicio de urgencias. Método: Este estudio retrospectivo incluyó a pacientes que acudieron al servicio de urgencias con sospecha de sepsis, donde se evaluó la eficacia de varios sistemas de puntuación. Se evaluó la capacidad diagnóstica de las pruebas midiendo la especificidad, la sensibilidad, los valores predictivos positivos y negativos, así como las áreas bajo la curva (AUC) de cada puntuación para predecir la mortalidad. Resultados: El estudio incluyó a 383 pacientes que habían acudido al servicio de urgencias. La tasa de mortalidad global fue del 20,6 %, y la tasa de mortalidad, precisamente por shock séptico, fue del 35,2 %. Los valores del AUC para predecir las muertes hospitalarias por sepsis fueron los siguientes: qSOFA: 0,68 (IC del 95 %: 0,62-0,74); NEWS: 0,71 (IC del 95 %: 0,64-0,77); IEWS: 0,74 (IC del 95 %: 0,68-0,80); IEWS_L: 0,81 (IC del 95 %: 0,76-0,86). Conclusiones: En el servicio de urgencias, la escala IEWS demostró ser la más eficaz para predecir con precisión la mortalidad hospitalaria por sepsis en comparación con las escalas qSOFA y NEWS. Además, la incorporación del nivel de lactato sérico en la escala IEWS mejora significativamente su capacidad para predecir la mortalidad.
dc.description.abstractIntroduction: Sepsis has a high mortality rate, especially in low-income countries. Improving outcomes depends on the early recognition of patients at risk of death. Therefore, rapid and applicable prediction scores are needed in emergency triage. Objective: This study assessed the effectiveness of the qSOFA, NEWS, and IEWS scales in predicting in-hospital mortality during emergency triage. Additionally, we analyzed the efficacy of the IEWS_L, which integrates the IEWS with arterial lactate levels measured upon admission to the emergency department. Method: This retrospective study included patients who consulted the emergency department with suspected sepsis, where various scoring systems were evaluated for their effectiveness. We evaluated the diagnostic capacity of the tests by measuring the specificity, sensitivity, positive and negative predictive values, as well as the areas under the curve (AUC) of each score to predict mortality. Results: The study included 383 patients who had visited the emergency department. The overall mortality rate was 20.6%, and the mortality rate, precisely due to septic shock, was 35.2%. The AUC values for predicting in-hospital deaths due to sepsis were as follows: qSOFA: 0.68 (95% CI: 0.62–0.74); NEWS: 0.71 (95% CI: 0.64–0.77); IEWS: 0.74 (95% CI: 0.68–0.80); IEWS_L: 0.81 (95% CI: 0.76–0.86). Conclusions: In the emergency department, the IEWS scale demonstrated the best ability to accurately predict in-hospital mortality from sepsis when compared to the qSOFA and NEWS scale. Additionally, incorporating the serum lactate level into the IEWS scale significantly enhances its capacity to predict mortality.
dc.format.extent12 pp
dc.format.mimetypeapplication/pdf
dc.geoLocationBogotá, Colombia.
dc.identifier.doihttps://doi.org/10.3390/jcm14144869
dc.identifier.issn2077-0383
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/46313
dc.language.isoeng
dc.relation.urihttps://www.mdpi.com/2077-0383/14/14/4869
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectSepsis
dc.subjectMortalidad
dc.subjectqSOFA
dc.subjectIEWS, NEWS, IEWS_L
dc.subject.keywordSepsis
dc.subject.keywordMortality
dc.subject.keywordqSOFA
dc.subject.keywordIEWS
dc.subject.keywordNEWS
dc.subject.keywordIEWS_L
dc.titleEvaluating Sepsis Mortality Predictions from the Emergency Department: A Restrospective Cohort Study Comparing qSOFA, the National Early Warning Score, and the International Early Warning Score
dc.typejournalArticle
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaDescriptivo observacional retrospectivo
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