EVALUATING SEPSIS AND SEPTIC SHOCK: A REVIEW OF DIAGNOSTIC AND PREDICTIVE TOOLS
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Keywords
Sepsis, septic shock, SOFA score, qSOFA score, Shock Index, modified SOFA score, Phoenix Sepsis Criteria
Abstract
Background: Sepsis remains a critical global health issue, contributing to up to 20% of all-cause deaths worldwide, especially within hospital settings. The complexity of sepsis, along with its progression to septic shock, necessitates effective screening and predictive tools for early identification and management.
Objective: This review evaluates the efficacy and utility of various screening and predictive tools used in sepsis and septic shock, including the Sequential Organ Failure Assessment (SOFA) score, quick SOFA (qSOFA) score, modified SOFA (mSOFA), and the Shock Index (SI).
Methods: We conducted a comprehensive review of current literature on these tools' performance in predicting mortality and assessing severity in sepsis. Key studies were analyzed to compare their sensitivity, specificity, and practical application in different clinical settings.
Results: The SOFA score, assessing six organ systems, has demonstrated high accuracy in predicting mortality and organ failure, with changes of 2 or more points indicating sepsis syndrome. The qSOFA score, while useful for rapid identification outside ICU settings, has shown variable sensitivity in diagnosing sepsis and predicting mortality. The SI and mSI have proven valuable in assessing shock severity and predicting hospital admission and mortality. Recent advances include the Phoenix Sepsis Criteria, which offer improved performance in pediatric sepsis identification.
Conclusion: Effective management of sepsis and septic shock relies on integrating multiple screening tools with continuous monitoring of organ functions. While the SOFA score remains a robust tool for assessing acute morbidity, the qSOFA, SI, and mSI scores provide additional insights for rapid triage and severity assessment. Future developments in sepsis criteria, such as the Phoenix Sepsis Criteria, hold promise for enhancing diagnostic accuracy and patient outcomes.
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Rizwanullah
Department of Medicine, Hayatabad Medical Complex, Pakistan
Isha Patel
Department of Medicine, GMERS Medical College, India
Fardin Akbar Hyderi
Department of Medicine, Bangladesh Medical College, Bangladesh
Hashem Elessawy
Department of Medicine, New York Institute of Technology College of osteopathic Medicine, USA
Moutushi Ahmed
Department of Research, Michigan Advanced Neurology Center, USA
Pranaya Rajbhandari
Department of Medicine, Patan Academy of Health Science, Nepal