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dc.contributor.authorShibata, Junichiro
dc.contributor.authorOsawa, Itsuki
dc.contributor.authorIto, Honoka
dc.contributor.authorSoeno, Shoko
dc.contributor.authorHara, Konan
dc.contributor.authorSonoo, Tomohiro
dc.contributor.authorNakamura, Kensuke
dc.contributor.authorGoto, Tadahiro
dc.date.accessioned2021-10-15T21:38:01Z
dc.date.available2021-10-15T21:38:01Z
dc.date.issued2021-12
dc.identifier.citationShibata, J., Osawa, I., Ito, H., Soeno, S., Hara, K., Sonoo, T., Nakamura, K., & Goto, T. (2021). Risk factors of sepsis among patients with qSOFA<2 in the emergency department. American Journal of Emergency Medicine, 50, 699–706.en_US
dc.identifier.issn0735-6757
dc.identifier.doi10.1016/j.ajem.2021.09.035
dc.identifier.urihttp://hdl.handle.net/10150/662084
dc.description.abstractObjective: Studies have suggested that qSOFA can be used for early detection of sepsis immediately upon arrival at the emergency department (ED). Despite this, little is known about the risk factors associated with the subsequent diagnosis of sepsis among patients with qSOFA<2 in the ED. Methods: This is a retrospective cohort study using ED data from a large tertiary medical center in Japan, 2018–2020. We included adult patients (aged ≥18 years) presenting to the ED with suspected infection (e.g., having a fever) and qSOFA<2. We identified patients who developed sepsis based on the Sepsis-3 criteria, and compared patient characteristics (e.g., demographics, vital signs upon the initial triage, chief complaint, and comorbidities) between patients who developed sepsis or not. Additionally, we identified the potential risk factors of sepsis among patients with qSOFA<2 using a multivariable logistic regression model. Results: We identified 151 (7%) patients who developed sepsis among 2025 adult patients with suspected infection and qSOFA<2. Compared with patients who did not develop sepsis, patients who developed sepsis were likely to be older and have vital signs suggestive of imminent sepsis (e.g., high respiratory rate). In the multivariable logistic regression model, the potential risk factors of sepsis among patients with qSOFA<2 were older age (adjusted OR, 1.92 [95%CI 1.19–3.19]), vital signs suggestive of imminent sepsis (e.g., adjusted OR of altered mental status, 3.50 [95%CI 2.25–5.50]), receipt of oxygen therapy upon arrival at the ED (adjusted OR, 1.91 [95%CI 1.38–2.26]), chief complaint of sore throat (adjusted OR, 2.15 [95%CI 1.08–4.13]), and the presence of comorbid diabetes mellitus, ischemic heart disease, and chronic kidney disease (e.g., adjusted OR of diabetes mellitus, 1.47 [95%CI 1.10–1.96]). On the contrary, chief complaint of abdominal and chest pain were associated with a lower risk of sepsis (e.g., adjusted OR of abdominal pain, 0.26 [95%CI 0.14–0.45]). Conclusions: We found that older age, vital signs prognosticating sepsis, and the presence of some comorbidities were the potential risk factors of sepsis in patients with qSOFA<2. These potential risk factors could be useful to efficiently recognize patients who might develop sepsis in the ED.en_US
dc.language.isoenen_US
dc.publisherElsevier BVen_US
dc.rights© 2021 Elsevier Inc. All rights reserved.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en_US
dc.subjectEmergency departmenten_US
dc.subjectqSOFAen_US
dc.subjectSepsisen_US
dc.subjectTriageen_US
dc.subjectVital signsen_US
dc.titleRisk factors of sepsis among patients with qSOFA<2 in the emergency departmenten_US
dc.typeArticleen_US
dc.contributor.departmentDepartment of Economics, University of Arizonaen_US
dc.identifier.journalAmerican Journal of Emergency Medicineen_US
dc.description.note12 month embargo; available online: 27 September 2021en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.identifier.piiS0735675721007737
dc.source.journaltitleThe American Journal of Emergency Medicine
dc.source.volume50
dc.source.beginpage699
dc.source.endpage706


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