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P242 Concurrent validity of sequential organ failure assessment versus systemic inflammatory response syndrome score for patients in the intensive care unit.
Poster Walks Poster Walk 8: Interstitial lung disease/ICU/Pediatrics
P242 Concurrent validity of sequential organ failure assessment versus systemic inflammatory response syndrome score for patients in the intensive care unit. B. Donald1, G. Udeani1,2, S. Surani3,4,5, L. Azali1,2, H. Patel1,2 1 Pharmacy, Corpus Christi Medical Center, Corpus Christi, 2College of Pharmacy, Texas A&M University, Kingsville, 3 Pulmonology, Corpus Christi Medical Center, Corpus Christi, 4Pulmonary Fellowship Director, University of North Texas, Denton, 5College of Medicine, Texas A&M University, Bryan, United States Introduction: The Third International Consensus Definitions for Sepsis and Septic Shock updated the definition of sepsis to match the former definition of severe sepsis and the screen used to assess sepsis from systemic inflammatory response syndrome (SIRS) to the sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) score. We reviewed ICU patients at our institution to determine the impact of changing our usual assessment for sepsis. Methods: Retrospective chart review of 21 patients in the ICU with confirmed or suspected infection in October 2016 was conducted. Physician orders for anti-infectives and cultures were used as a surrogate for suspected infection. Surgical patients were excluded to avoid confounding results. SIRS, SOFA, and qSOFA scores were calculated at each assessment and lab result. Concurrence was assessed for both SOFA and qSOFA with regards to SIRS by the incidence of simultaneous positive scores and the lag time between positive scores. The time between first positive result for each score was measured when one score showed a negative result before concurrence. The lag time between positive results when concurrent and the time between first positive results were assessed using descriptive statistics.
POSTER WALKS
Results: Concurrent positive SOFA-SIRS and qSOFA-SIRS scores were observed in 16/21 and 15/21 patients respectively. A positive SOFA score preceded a positive SIRS score in 9/16 patients (mean 5.673.24 hours); positive SOFA followed positive SIRS in 5/16 patients (mean 3.96.47 hours). A positive qSOFA score preceded a positive SIRS score in 1/15 patients (0.5 hours); positive qSOFA followed positive SIRS in 7/15 patients (mean 13.735.32 hours). 3/16 patients had a first positive SIRS before concurrence with SOFA (mean 21.2824.74 hours) and 8/15 patients had a first positive SIRS before concurrence with qSOFA (mean 6.674.53 hours). Conclusions: Both SOFA and qSOFA show some concurrence with SIRS in ICU patients. SOFA tends to show a positive result before SIRS, and could be used as an early warning for sepsis. These data should be correlated with clinical outcomes to determine impact on patient care. DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.149
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
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P242 Concurrent validity of sequential organ failure assessment versus systemic inflammatory response syndrome score for patients in the intensive care unit. B. Donald1, G. Udeani1,2, S. Surani3,4,5, L. Azali1,2, H. Patel1,2 1 Pharmacy, Corpus Christi Medical Center, Corpus Christi, 2College of Pharmacy, Texas A&M University, Kingsville, 3 Pulmonology, Corpus Christi Medical Center, Corpus Christi, 4Pulmonary Fellowship Director, University of North Texas, Denton, 5College of Medicine, Texas A&M University, Bryan, United States Introduction: The Third International Consensus Definitions for Sepsis and Septic Shock updated the definition of sepsis to match the former definition of severe sepsis and the screen used to assess sepsis from systemic inflammatory response syndrome (SIRS) to the sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) score. We reviewed ICU patients at our institution to determine the impact of changing our usual assessment for sepsis. Methods: Retrospective chart review of 21 patients in the ICU with confirmed or suspected infection in October 2016 was conducted. Physician orders for anti-infectives and cultures were used as a surrogate for suspected infection. Surgical patients were excluded to avoid confounding results. SIRS, SOFA, and qSOFA scores were calculated at each assessment and lab result. Concurrence was assessed for both SOFA and qSOFA with regards to SIRS by the incidence of simultaneous positive scores and the lag time between positive scores. The time between first positive result for each score was measured when one score showed a negative result before concurrence. The lag time between positive results when concurrent and the time between first positive results were assessed using descriptive statistics.
POSTER WALKS
Results: Concurrent positive SOFA-SIRS and qSOFA-SIRS scores were observed in 16/21 and 15/21 patients respectively. A positive SOFA score preceded a positive SIRS score in 9/16 patients (mean 5.673.24 hours); positive SOFA followed positive SIRS in 5/16 patients (mean 3.96.47 hours). A positive qSOFA score preceded a positive SIRS score in 1/15 patients (0.5 hours); positive qSOFA followed positive SIRS in 7/15 patients (mean 13.735.32 hours). 3/16 patients had a first positive SIRS before concurrence with SOFA (mean 21.2824.74 hours) and 8/15 patients had a first positive SIRS before concurrence with qSOFA (mean 6.674.53 hours). Conclusions: Both SOFA and qSOFA show some concurrence with SIRS in ICU patients. SOFA tends to show a positive result before SIRS, and could be used as an early warning for sepsis. These data should be correlated with clinical outcomes to determine impact on patient care. DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.149
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
142A
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151#5S CHEST MAY 2017
]