Early Goal Directed Therapy
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
In-Hospital Mortality
|
Patient
|
ED-MD
|
Rivers E., et al. Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock. N Engl J Med 2001; 345(19):1368-77. Medline
|
I
|
Neutral (Yellow)
|
90 day mortality
|
Patient
|
ED-MD
|
ARISE Investigators, ANZICS Clinical Trials Group, Peake SL, et al. Goal-directed resuscitation for patients with early septic shock. N Engl J Med 2014; 371(16):1496-1506. Medline
|
I
|
Neutral (Yellow)
|
All-cause mortality
|
Patient
|
|
Jiang LB., Zhang M., Jiang SY., Ma YF. Early goal-directed resuscitation for patients with severe sepsis and septic shock: a meta-analysis and trial sequential analysis. Scand J Trauma Resusc Emerg Med 2016; 24:23-016-0214-7. Medline
|
I
|
Neutral (Yellow)
|
All-cause 90 day mortality
|
Patient
|
ED-MD
|
Mouncey P., Osborn T., Power GS., et al. Protocolised Management In Sepsis (ProMISe): a multicentre randomised controlled trial of the clinical effectiveness and cost-effectiveness of early, goal-directed, protocolised resuscitation for emerging septic shock. Health Technology Assessment 2015; 19:97. Medline
|
I
|
Neutral (Yellow)
|
Mortality
|
Patient
|
ED-MD
|
ProCESS Investigators, Yealy DM., Kellum JA., et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med 2014; 370(18):1683-93. Medline
|
I
|
Neutral (Yellow)
|
90 day mortality
|
Patient
|
ED-MD
|
The PRISM Investigators*. Early, Goal-Directed Therapy for Septic Shock— A Patient-Level Meta-Analysis. N Engl J Med 2017; 376(23):2223-2234. Medline
|
I
|
Neutral (Yellow)
|
28 day mortality
|
Patient
|
ED-MD
|
Yu H., Chi D., Wang S., Liu B. Effect of early goal-directed therapy on mortality in patients with severe sepsis or septic shock: a meta-analysis of randomised controlled trials. BMJ Open 2016; 6(3):e008330-2015-008330. Medline
|
II
|
Supportive (Green)
|
In-Hospital Mortality
|
Patient
|
ED-MD
|
El KC, Abou DG, Chami A., Bou CR, Amoun T., Bachir R., et al. The Impact of EGDT on Sepsis Mortality in a Single Tertiary Care Center in Lebanon. Emergency medicine international 2019; 8747282. Medline
|
II
|
Supportive (Green)
|
Mortality
|
Patient
|
ED-MD
|
El Solh AA., Akinnusi ME., Alsawalha LN., Pineda LA. Outcome of Septic Shock in Older Adults After Implementation of the Sepsis Bundle. J Am Geriatr Soc 2008; 56:272-8. Medline
|
II
|
Supportive (Green)
|
Time to antibiotics
|
Process
|
ED-MD
|
Francis M., Rich T., Williamson T., Peterson D. Effect of an emergency department sepsis protocol on time to antibiotics in severe sepsis. CJEM 2010; 12(4):303-10. Medline
|
II
|
Supportive (Green)
|
28 day in-hospital mortality
|
Patient
|
ED-MD
|
Hanzelka KM., Yeung SC., Chisholm G., et al. Implementation of modified early-goal directed therapy for sepsis in the emergency center of a comprehensive cancer center. Support Care Cancer 2013; 21(3):727-34. Medline
|
II
|
Supportive (Green)
|
In-hospital mortality
|
Patient
|
ED-MD
|
Jones AE., Focht A., Horton JM., Kline JA. Prospective external validation of the clinical effectiveness of an emergency department-based early goal-directed therapy protocol for severe sepsis and septic shock. Chest 2007; 132(2):425-32. Medline
|
II
|
Supportive (Green)
|
Feasibility of implementation
|
Process
|
ED-MD
|
Nguyen HB., Corbett SW., Steele R., et al. Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality. Crit Care Med 2007; 35(4):1105-12. Medline
|
II
|
Supportive (Green)
|
28 day mortality
|
Patient
|
ED-MD
|
Permpikul C., Sringam P., Tongyoo S. Therapeutic goal achievements during severe sepsis and septic shock resuscitation and their association with patients' outcomes. J Med Assoc Thai 2014; 97(S3):S176-83. Medline
|
II
|
Supportive (Green)
|
In-hospital mortality
|
Patient
|
ED-MD
|
Prasad PA, Shea ER, Shiboski S, Sullivan MC, Gonzales R, Shimabukuro D. Relationship Between a Sepsis Intervention Bundle and In-Hospital Mortality Among Hospitalized Patients: A Retrospective Analysis of Real-World Data. Anesth Analg 2017; 125(2):507-13. Medline
|
II
|
Supportive (Green)
|
Mortality at 1 year
|
Patient
|
ED-MD
|
Puskarich MA., Marchick MR., Kline JA., Steuerwald MT., Jones AE. One year mortality of patients treated with an emergency department based early goal directed therapy protocol for severe sepsis and septic shock: a before and after study. Crit Care 2009; 13(5):R167. Medline
|
II
|
Supportive (Green)
|
In-hospital mortality rate
|
Patient
|
ED-MD
|
Sivayoham N., Rhodes A., Jaiganesh T., van Zyl Smit N., Elkhodhair S., Krishnanandan S. Outcomes from implementing early goal-directed therapy for severe sepsis and septic shock : A 4-year observational cohort study. Eur J Emerg Med 2012; 19(4):235-240. Medline
|
II
|
Supportive (Green)
|
Time to initiation of antibiotics in ED
|
Process
|
ED-MD
|
Studnek JR., Artho MR., Garner CL., Jr, Jones AE. The impact of emergency medical services on the ED care of severe sepsis. Am J Emerg Med 2012; 30(1):51-56. Medline
|
II
|
Neutral (Yellow)
|
Mortality
|
Patient
|
ED-MD
|
Crowe CA., Mistry CD., Rzechula K., Kulstad CE. Evaluation of a modified early goal-directed therapy protocol. Am J Emerg Med 2010; 28(6):689-93. Medline
|
II
|
Neutral (Yellow)
|
Mortality
|
Patient
|
ED-MD
|
Focht A., Jones AE., Lowe TJ. Early goal-directed therapy: Improving mortality and morbidity of sepsis in the emergency department. Jt Comm J Qual Patient Saf 2009; 35(4):186-91. Medline
|
II
|
Neutral (Yellow)
|
Achievement of EGDT benchmarks
|
Process
|
ED-MD
|
Worapratya P., Wanjaroenchaisuk A., Joraluck J., Wuthisuthimethawee P. Success of applying early goal-directed therapy for septic shock patients in the emergency department. Open Access Emerg Med 2016; 8:1-6. Medline
|
II
|
Opposes (Red)
|
Mortality
|
Patient
|
ED-MD
|
Ho BC., Bellomo R., McGain F., et al. The incidence and outcome of septic shock patients in the absence of early-goal directed therapy. Crit Care 2006; 10(3):R80. Medline
|
III
|
Supportive (Green)
|
Feasibility
|
Process
|
PH-Paramedic
|
Walchok JG., Pirrallo RG., Furmanek D., Lutz M., Shope C., Giles B., et al. Paramedic-Initiated CMS Sepsis Core Measure Bundle Prior to Hospital Arrival: A Stepwise Approach. Prehosp Emerg Care 2016; 05:1-10. Medline
|
Identification tools (other)
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
II
|
Supportive (Green)
|
Prediction of severe sepsis
|
Process
|
ED-MD
|
Askim Ã., Moser F., Gustad LT., Stene H., Gundersen M., Ãsvold BO., et al. Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality - a prospective study of patients admitted with infection to the emergency department. Scandinavian journal of trauma, resuscitation and emergency medicine 2017; 25(1):56. Medline
|
II
|
Supportive (Green)
|
Bundle compliance
|
Process
|
PH-Paramedic
|
Borrelli G, Koch E, Sterk E, Lovett S, Rech MA. Early recognition of sepsis through emergency medical services pre-hospital screening. Am J Emerg Med 2018. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Brink A, Alsma J, Verdonschot RJCG, Rood PPM, Zietse R, Lingsma HF, et al. (2019) Predicting mortality in patients with suspected sepsis at the Emergency Department; A
retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLoS ONE
14(1): e0211133 Medline
|
II
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
ED-MD
|
Cag Y., Karabay O., Sipahi OR., Aksoy F., Durmus G., Batirel A., et al. Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome. PloS one 2018; 13(9):e0204608. Medline
|
II
|
Supportive (Green)
|
Time to triage
|
Process
|
ED-MD
|
Carberry M., Harden J. A collaborative improvement project by an NHS Emergency Department and Scottish Ambulance Paramedics to improve the identification and delivery of sepsis 6. BMJ Qual Improv Rep 2016; 5(1):u212670.w5049. Medline
|
II
|
Supportive (Green)
|
Prediction of Mortality
|
Process
|
ED-MD
|
Chang SH., Hsieh CH., Weng YM., Hsieh MS., Goh ZNL., Chen HY., et al. Performance Assessment of the Mortality in Emergency Department Sepsis Score, Modified Early Warning Score, Rapid Emergency Medicine Score, and Rapid Acute Physiology Score in Predicting Survival Outcomes of Adult Renal Abscess Patients in the Emergency Department. BioMed research international 2018; 2018:6983568. Medline
|
II
|
Supportive (Green)
|
In-hospital mortality prediction
|
Process
|
ED-MD
|
Chen KF, Liu SH, Li CH, Wu CC, Chaou CH, Tzeng IS, et al. Development and validation of a parsimonious and pragmatic CHARM score to predict mortality in patients with suspected sepsis. Am J Emerg Med 2017; 35(4):640-6. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
ED-MD
|
Gilbert BW, Faires L, Meister A, Huffman J, Faber RK. Comparison of Sepsis-3 Criteria Versus SIRS Criteria in Screening Patients for Sepsis in the Emergency Department. Advanced emergency nursing journal 2018; 40(2):138-43. Medline
|
II
|
Supportive (Green)
|
Prediction of 30-day mortality.
|
Process
|
ED-MD
|
González del Castillo J, Escobar-Curbelo L, Martínez-Ortíz de Zárate F, García-Lamberechts J, Moreno-Cuervo Ã, et al. GYM score: 30-day mortality predictive model in elderly patients attended in the emergency department with infection. European journal of emergency medicine: official journal of the European Society for Emergency Medicine 2017; 24(3):183-8. Medline
|
II
|
Supportive (Green)
|
Prediction of 30-day mortality
|
Process
|
|
González del Castillo J, Julian-Jiménez A, González-Martínez F, Álvarez-Manzanares J, Piñera P, Navarro-Bustos C, et al. Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology 2017; 36(12):2361-9. Medline
|
II
|
Supportive (Green)
|
Positive predictive value of a sepsis score.
|
Process
|
PH-Paramedic
|
Goodacre S, Sutton L, Ennis K, et al. Prehospital early warning scores for adults with suspected sepsis: the PHEWS observational cohort and decision-analytic modelling study. Heal Technol Assess. March 2024; 28(16):1-93. Medline
|
II
|
Supportive (Green)
|
EMS identification of sepsis
|
Process
|
PH-Paramedic
|
Guerra WF., Mayfield TR., Meyers MS., Clouatre AE., Riccio JC. Early detection and treatment of patients with severe sepsis by prehospital personnel. J Emerg Med 2013; 44(6):1116-25. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
PH-Paramedic
|
Hunter C., Silvestri S., Ralls G., Stone A., Walker A., Mangalat N., et al. Comparing Quick Sequential Organ Failure Assessment Scores to End-tidal Carbon Dioxide as Mortality Predictors in Prehospital Patients with Suspected Sepsis. WestJEM 2018; 19(3):446–51. Medline
|
II
|
Supportive (Green)
|
Sepsis and severe sepsis in-hospital mortality
|
Patient
|
PH-Paramedic
|
Hunter CL., Silvestri S., Ralls G., Stone A., Walker A., Papa L. A prehospital screening tool utilizing end-tidal carbon dioxide predicts sepsis and severe sepsis. Am J Emerg Med 2016; 34(5):813-9. Medline
|
II
|
Supportive (Green)
|
% receiving antibiotics within 60 minutes of triage
|
Process
|
ED-MD
|
Idrees M., Macdonald SP., Kodali K. Sepsis Early Alert Tool: Early recognition and timely management in the emergency department. Emerg Med Australas 2016; 28(4):399-403. Medline
|
II
|
Supportive (Green)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Innocenti F., Tozzi C., Donnini C., De Villa E., Conti A., Zanobetti M., et al. SOFA score in septic patients: incremental prognostic value over age, comorbidities, and parameters of sepsis severity. Intern Emerg Med 2018; 13(3):405-412. Medline
|
II
|
Supportive (Green)
|
Prediction of admission
|
Process
|
ED-MD
|
Jiang L., Caputo ND., Chang BP. Respiratory adjusted shock index for identifying occult shock and level of Care in Sepsis Patients. Am J Emerg Med 2019; 37(3):506-9. Medline
|
II
|
Supportive (Green)
|
Prediction of ICU admission
|
Process
|
PH-Paramedic
|
Jouffroy R., Saade A., Ellouze S., Carpentier A., Michaloux M., Carli P., et al. Prehospital triage of septic patients at the SAMU regulation: Comparison of qSOFA, MRST, MEWS and PRESEP scores. Am J Emerg Med 2018; 36(5):820-4. Medline
|
II
|
Supportive (Green)
|
Accuracy of prehospital identification
|
Process
|
PH-Paramedic
|
Lane D., Ichelson R., Drennan I., Scales D. Prehospital management and identification of sepsis by emergency medical services: a systematic review. Emerg Med J 2016; 33:408–413. Medline
|
II
|
Supportive (Green)
|
Area under
the receiver operating characteristic (AUROC) curve for detection and prediction of sepsis, severe sepsis and septic shock
|
Process
|
|
Mao Q, Jay M, Hoffman JL, Calvert J, Barton C, Shimabukuro D, et al. Multicentre validation of a sepsis prediction algorithm using only vital sign data in the emergency department, general ward and ICU. BMJ open 2018; 8(1):e017833. Medline
|
II
|
Supportive (Green)
|
Accuracy
|
Process
|
PH-Paramedic & MD
|
Martín-Rodríguez F, Sanz-García A, del Poza Vegas C, Ortega GJ, Castro Villamor MA, López-Izquierdo R. Time for a prehospital-modified sequential organ failure assessment score: An ambulance-Based cohort study. Am J Emerg Med 2021; 49:331–7. Medline
|
II
|
Supportive (Green)
|
Time to treatment
|
Process
|
ED-MD
|
McDonald CM., West S., Dushenski D., Lapinsky SE., Soong C., van den BK, et al. Sepsis now a priority: a quality improvement initiative for early sepsis recognition and care. International journal for quality in health care 2018; 30(10):802-9. Medline
|
II
|
Supportive (Green)
|
AUC for predicting diagnosis of sepsis within 48h
|
Process
|
PH-Paramedic
|
Nualprasert P, Pattanarattanamolee R, Padtalaka P, Nakahara S. Evaluation of the PRESEP Score and the Miami Sepsis Score for Prehospital Sepsis Screening. Prehosp Emerg Care January 2024; 28(2):369-74. Medline
|
II
|
Supportive (Green)
|
Proportion of patients with sepsis who were identified by EMS
|
Process
|
PH-Paramedic
|
Polito CC, Bloom I, Dunn C, Moore R, Chen J, Yancey AH 2nd, Sevransky JE. Implementation of an EMS protocol to improve prehospital sepsis recognition. Am J Emerg Med 2022; 57:34–8. Medline
|
II
|
Supportive (Green)
|
Prediction of direct ICU admission
|
Process
|
ED-MD
|
Quinten VM., van MM, Wolffensperger AE., Ter MJ, Ligtenberg JJM. Sepsis patients in the emergency department: stratification using the Clinical Impression Score, Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score? European journal of emergency medicine 2018; 25(5):328-34. Medline
|
II
|
Supportive (Green)
|
Prediction of all-cause in-hospital mortality
|
Process
|
ED-MD
|
Ranzani OT, Prina E, Menéndez R, Ceccato A, Cilloniz C, et al. New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study. American journal of respiratory and critical care medicine 2017; 196(10):1287-97. Medline
|
II
|
Supportive (Green)
|
Time to antibiotics
|
Process
|
|
Rosenqvist M., Fagerstrand E., Lanbeck P., Melander O., Akesson P. Sepsis Alert - a triage model that reduces time to antibiotics and length of hospital stay. Infect Dis (Lond) 2017; 49(7):507-13. Medline
|
II
|
Supportive (Green)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Saeed K., Wilson DC., Bloos F., Schuetz P., van der DY, Melander O., et al. The early identification of disease progression in patients with suspected infection presenting to the emergency department: a multi-centre derivation and validation study. Crit Care 2019; 23(1):40. Medline
|
II
|
Supportive (Green)
|
Prediction of 30 in-hospital mortality
|
Process
|
|
Samsudin MI, Liu N, Prabhakar SM, Chong SL, Kit LW, Koh ZX, et al. A novel heart rate variability based risk prediction model for septic patients presenting to the emergency department. Medicine 2018; 97(23):e10866. Medline
|
II
|
Supportive (Green)
|
Predictive value
|
Process
|
ED-MD
|
Sparks R, Harada A, Chavada R, Trethewy C. Comparison of different sepsis scoring systems and pathways: qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in bacteraemic and non-bacteraemic patients presenting to the emergency department. BMC Infect Dis 2022; 22(1):76. Medline
|
II
|
Supportive (Green)
|
Predictive value
|
Process
|
Other
|
Wallgren UM, Sjölin J, Järnbert-Pettersson H, Kurland L. Performance of NEWS2, RETTS, clinical judgment and the Predict Sepsis screening tools with respect to identification of sepsis among ambulance patients with suspected infection: a prospective cohort study. Scand J Trauma Resusc Emerg Med 2021; 29(1):144. Medline
|
II
|
Neutral (Yellow)
|
Predicting sepsis
|
Process
|
ED-MD
|
Filbin MR., Thorsen JE., Lynch J., Gillingham TD., Pasakarnis CL., Capp R., et al. Challenges and Opportunities for Emergency Department Sepsis Screening at Triage. Scientific reports 2018; 8(1):11059. Medline
|
II
|
Neutral (Yellow)
|
Sepsis identification
|
Process
|
PH-Paramedic
|
Green R., Travers A., Cain E., et al. Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study. Emerg Med Int 2016; 2016:6717261 Medline
|
II
|
Neutral (Yellow)
|
Bundle compliance
|
Process
|
ED-MD
|
Shah T., Sterk E., Rech MA. Emergency department sepsis screening tool decreases time to antibiotics in patients with sepsis. Am J Emerg Med 2018; 36(10):1745-8. Medline
|
II
|
Neutral (Yellow)
|
Prediction of sepsis
|
Process
|
ED-MD
|
Shetty AL., Brown T., Booth T., Van KL., Dor-Shiffer DE., Vaghasiya MR., et al. Systemic inflammatory response syndrome-based severe sepsis screening algorithms in emergency department patients with suspected sepsis. Emerg Med Australas 2016; 28(3):287-294. Medline
|
II
|
Neutral (Yellow)
|
ICU admission within 48 h
|
Process
|
PH-Paramedic
|
Silcock DJ, Corfield AR, Rooney KD, Staines H. Superior performance of National Early Warning Score compared with quick Sepsis-related Organ Failure Assessment Score in predicting adverse outcomes: a retrospective observational study of patients in the prehospital setting. European journal of emergency medicine: official journal of the European Society for Emergency Medicine 2018. Medline
|
II
|
Neutral (Yellow)
|
Prediction of all-causes mortality from sepsis.
|
Process
|
ED-MD
|
Sivayoham N, Hussein AN, Shabbo L, Christie D. An observational cohort study of the performance of the REDS score compared to the SIRS criteria, NEWS2, CURB65, SOFA, MEDS and PIRO scores to risk-stratify emergency department suspected sepsis. Ann Med 2021; 53(1):1863–74. Medline
|
III
|
Supportive (Green)
|
Diagnosis of sepsis
|
Process
|
ED-MD
|
Althunayyan SM., Alsofayan YM., Khan AA. Shock index and modified shock index as triage screening tools for sepsis. Journal of infection and public health 2019; 12(6):822-6. Medline
|
III
|
Supportive (Green)
|
Prediction of all-cause mortality
|
Process
|
In-Patient
|
Henning DJ, Puskarich MA, Self WH, Howell MD, Donnino MW, Yealy DM, et al. An Emergency Department Validation of the SEP-3 Sepsis and Septic Shock Definitions and Comparison With 1992 Consensus Definitions. Ann Emerg Med 2017; 70(4):544-52.e5. Medline
|
III
|
Supportive (Green)
|
Sepsis identification
|
Process
|
PH-Paramedic
|
Lane DJ, Wunsch H, Saskin R, et al. Screening strategies to identify sepsis in the prehospital setting: a validation study. CMAJ. 2020;192(10):E230–E239. doi:10.1503/cmaj.190966 Medline
|
III
|
Supportive (Green)
|
Detection of sepsis
|
Process
|
PH-Paramedic
|
Smyth MA., Brace-McDonnell SJ., Perkins GD. Identification of adults with sepsis in the prehospital environment: a systematic review. BMJ Open 2016; 6(8):e011218-2016-011218. Medline
|
III
|
Supportive (Green)
|
Predicting critical illness
|
Process
|
PH-Paramedic
|
Smyth MA., Gallacher D., Kimani PK., Ragoo M., Ward M., Perkins GD. Derivation and internal validation of the screening to enhance prehospital identification of sepsis (SEPSIS) score in adults on arrival at the emergency department. Scandinavian journal of trauma, resuscitation and emergency medicine 2019; 27(1):67. Medline
|
III
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
PH-Paramedic
|
Wallgren UM., Bohm KEM., Kurland L. Presentations of adult septic patients in the prehospital setting as recorded by emergency medical services: a mixed methods analysis. Scand J Trauma Resusc Emerg Med 2017; 25(1):23. Medline
|
III
|
Supportive (Green)
|
Time to diagnosis
|
Process
|
ED-MD
|
Westphal GA., Pereira AB., Fachin SM., Sperotto G., Gonçalves M., Albino L., et al. An electronic warning system helps reduce the time to diagnosis of sepsis. Revista Brasileira de terapia intensive 2018; 30(4):414-22. Medline
|
III
|
Neutral (Yellow)
|
Prediction of sepsis
|
Process
|
PH-Paramedic
|
Baez AA., Cochon L. Acute Care Diagnostics Collaboration: Assessment of a Bayesian clinical decision model integrating the Prehospital Sepsis Score and point-of-care lactate. Am J Emerg Med 2016; 34(2):193-6. Medline
|
III
|
Opposes (Red)
|
Prediction of sepsis
|
Process
|
ED-MD
|
Gräff I, Goldschmidt B, Glien P, Dolscheid-Pommerich RC, Fimmers R, Grigutsch D. Validity of the Manchester Triage System in patients with sepsis presenting at the ED: a first assessment. Emergency medicine journal: EMJ 2017; 34(4):212-8. Medline
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Lan, L., Zhou, M., Chen, X., Dai, M., Wang, L., & Li, H. (2024). Prognostic accuracy of SOFA, MEWS, and SIRS criteria in predicting the mortality rate of patients with sepsis: A meta-analysis. Nursing in critical care, 29(6), 1623–1635. https://doi.org/10.1111/nicc.13016 Medline
|
Identification tools- qSOFA
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Predictive value
|
Process
|
ED-MD
|
Svendsen M, Steindal SA, Hamilton Larsen M, Trygg Solberg M. Comparison of the systematic Inflammatory response syndrome and the quick sequential organ failure assessment for prognostic accuracy in detecting sepsis in the emergency department: A systematic review. Int Emerg Nurs 2023; 66:101242. Medline
|
I
|
Neutral (Yellow)
|
Predicting sepsis
|
Process
|
ED-MD
|
Sparks R, Harada A, Chavada R, Trethewy C. Comparison of different sepsis scoring systems and pathways: qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in bacteraemic and non-bacteraemic patients presenting to the emergency department. BMC Infect Dis 2022; 22(1):76. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
ED-MD
|
April MD., Aguirre J., Tannenbaum LI., Moore T., Pingree A., Thaxton RE., et al. Sepsis Clinical Criteria in Emergency Department Patients Admitted to an Intensive Care Unit: An External Validation Study of Quick Sequential Organ Failure Assessment. J Emerg Med 2017; 52(5):622-31. Medline
|
II
|
Supportive (Green)
|
Predictive value
|
Process
|
ED-MD
|
Báez AA, López O, Martínez MDP, Libell N, Cochón L, Nicolás JM. Clinical validation demonstrates concordance of qSOFA and POC lactate Bayesian model: Results from the ACDC Phase-2 program. Am J Emerg Med 2020. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Brink A, Alsma J, Verdonschot RJCG, Rood PPM, Zietse R, Lingsma HF, et al. (2019) Predicting mortality in patients with suspected sepsis at the Emergency Department; A
retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLoS ONE
14(1): e0211133 Medline
|
II
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
ED-MD
|
Cag Y., Karabay O., Sipahi OR., Aksoy F., Durmus G., Batirel A., et al. Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome. PloS one 2018; 13(9):e0204608. Medline
|
II
|
Supportive (Green)
|
Time to targeted sepsis therapy
|
Process
|
PH-Paramedic & MD
|
Dankert A, Kraxner J, Breitfeld P, Bopp C, Issleib M, Doehn C, et al. Is Prehospital Assessment of qSOFA Parameters Associated with Earlier Targeted Sepsis Therapy? A Retrospective Cohort Study. J Clin Med 2022; 11(12). Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
PH-Paramedic
|
Floer M, Ziegler M, Lenkewitz B, Auer A, Meister T. Out-of-hospital sepsis recognition by paramedics improves the course of disease and mortality: A single center retrospective study. Adv Clin Exp Med 2021. Medline
|
II
|
Supportive (Green)
|
Prediction of 30-day mortality
|
Process
|
|
González del Castillo J, Julian-Jiménez A, González-Martínez F, Álvarez-Manzanares J, Piñera P, Navarro-Bustos C, et al. Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology 2017; 36(12):2361-9. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
In-Patient
|
Guarino M, Perna B, De Giorgi A, Gambuti E, Alfano F, et al. A 2-year retrospective analysis of the prognostic value of MqSOFA compared to lactate, NEWS and qSOFA in patients with sepsis. Infection 2022;50(4):941–8. Medline
|
II
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
PH-Paramedic
|
Harada M., Takahashi T., Haga Y., Nishikawa T. Comparative study on quick sequential organ failure assessment, systemic inflammatory response syndrome and the shock index in prehospital emergency patients: single-site retrospective study. Acute medicine & surgery 2019; 6(2):131-7. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
PH-Paramedic
|
Hunter C., Silvestri S., Ralls G., Stone A., Walker A., Mangalat N., et al. Comparing Quick Sequential Organ Failure Assessment Scores to End-tidal Carbon Dioxide as Mortality Predictors in Prehospital Patients with Suspected Sepsis. WestJEM 2018; 19(3):446–51. Medline
|
II
|
Supportive (Green)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Innocenti F., Tozzi C., Donnini C., De Villa E., Conti A., Zanobetti M., et al. SOFA score in septic patients: incremental prognostic value over age, comorbidities, and parameters of sepsis severity. Intern Emerg Med 2018; 13(3):405-412. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Kwak H., Suh GJ., Kim T., Kwon WY., Kim KS., Jung YS., et al. Prognostic performance of Emergency Severity Index (ESI) combined with qSOFA score. Am J Emerg Med 2018; 36(10):1784-8. Medline
|
II
|
Supportive (Green)
|
Detection of culture-positive sepsis
|
Process
|
ED-MD
|
Mignot-Evers L, Raaijmakers V, Buunk G, Brouns S, Romano L, T van H, et al. Comparison of SIRS criteria and qSOFA score for identifying culture-positive sepsis in the emergency department: a prospective cross-sectional multicentre study. BMJ Open 2021; 11(6):e041024. Medline
|
II
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
Other
|
Miyamoto K., Shibata N., Nakashima T., Kato S. Prehospital quick sequential organ failure assessment as a tool to predict in-hospital mortality. Am J Emerg Med 2018; 36(10) 1832-6. Medline
|
II
|
Supportive (Green)
|
Prediction of organ failure
|
Process
|
ED-MD
|
Park HK, Kim WY, Kim MC, Jung W, Ko BS. Quick sequential organ failure assessment compared to systemic inflammatory response syndrome for predicting sepsis in emergency department. J Crit Care 2017; 42:12-7. Medline
|
II
|
Supportive (Green)
|
Prediction of direct ICU admission
|
Process
|
ED-MD
|
Quinten VM., van MM, Wolffensperger AE., Ter MJ, Ligtenberg JJM. Sepsis patients in the emergency department: stratification using the Clinical Impression Score, Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score? European journal of emergency medicine 2018; 25(5):328-34. Medline
|
II
|
Supportive (Green)
|
Prediction of critical illness
|
Process
|
ED-MD
|
Rodriguez RM, Greenwood JC, Nuckton TJ, Darger B, Shofer FS, Troeger D, et al. Comparison of qSOFA with current emergency department tools for screening of patients with sepsis for critical illness. Emergency medicine journal: EMJ 2018; 35(6):350-6. Medline
|
II
|
Supportive (Green)
|
Accuracy in predicting ICU admission or mortality.
|
Process
|
ED-MD
|
Sabir L, Ramlakhan S, Goodacre S. Comparison of qSOFA and Hospital Early Warning Scores for prognosis in suspected sepsis in emergency department patients: a systematic review. Emerg Med J 2022; 39(4):284–94. Medline
|
II
|
Supportive (Green)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Saeed K., Wilson DC., Bloos F., Schuetz P., van der DY, Melander O., et al. The early identification of disease progression in patients with suspected infection presenting to the emergency department: a multi-centre derivation and validation study. Crit Care 2019; 23(1):40. Medline
|
II
|
Supportive (Green)
|
Sepsis diagnosis (based on the Sepsis-3 criteria)
|
Process
|
ED-Paramedic & MD
|
Saito A, Osawa I, Shibata J, Sonoo T, Nakamura K, Goto T. The prognostic utility of prehospital qSOFA in addition to emergency department qSOFA for sepsis in patients with suspected infection: A retrospective cohort study. PLoS One 2023; 18(2):e0282148. Medline
|
II
|
Supportive (Green)
|
Prediction of 30 day mortality
|
Process
|
ED-MD
|
Samsudin MI., Liu N., Prabhakar SM., Chong SL., Kit LW, Koh ZX., et al. A novel heart rate variability based risk prediction model for septic patients presenting to the emergency department. Medicine 2018; 97(23):e10866. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
PH-Paramedic
|
Shu E, Ives TC, Frye W, Boyajian JG, Farshidpour L, Young M, et al. Pre-hospital qSOFA as a predictor of sepsis and mortality. Am J Emerg Med 2018. Medline
|
II
|
Supportive (Green)
|
Prediction of 28-day mortality
|
Process
|
PH-Paramedic
|
Usul E, Korkut S, Kayipmaz AE, Halici A, Kavalci C. The role of the quick sequential organ failure assessment score (qSOFA) and modified early warning score (MEWS) in the pre-hospitalization prediction of sepsis prognosis. Am J Emerg Med 2021; 41:158-62. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Patient
|
ED-MD
|
Wang C, Xu R, Zeng Y, Zhao Y, Hu X. A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis. PLoS One 2022; 17(4):e0266755. Medline
|
II
|
Supportive (Green)
|
Prediction of 30 day mortality
|
Process
|
ED-MD
|
Williams JM., Greenslade JH., McKenzie JV., Chu K., Brown AFT., Lipman J. Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection. Chest 2017; 151(3):586-96. Medline
|
II
|
Supportive (Green)
|
Prediction of 30-day mortality
|
Patient
|
ED-MD
|
Yeşil O, Pekdemir M, Özturan İU, Doğan NÖ, Yaka E, et al. Performance of qSOFA, SIRS, and the qSOFA + SIRS combinations for predicting 30-day adverse outcomes in patients with suspected infection. Med Klin Intensivmed Notfmed Nov 2022; 117(8):623–9. Medline
|
II
|
Neutral (Yellow)
|
Prediction of severe sepsis
|
Process
|
ED-MD
|
Askim Ã., Moser F., Gustad LT., Stene H., Gundersen M., Ãsvold BO., et al. Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality - a prospective study of patients admitted with infection to the emergency department. Scandinavian journal of trauma, resuscitation and emergency medicine 2017; 25(1):56. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Boulos D., Shehabi Y., Moghaddas JA., Birrell M., Choy A., Giang V., et al. Predictive value of quick Sepsis-Related Organ Failure Scores following sepsis-related Medical Emergency Team calls: a retrospective cohort study. Anaesth Intensive Care 2017; 45(6):688-94. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Churpek MM., Snyder A., Han X., Sokol S., Pettit N., Howell MD., et al. Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit. American journal of respiratory and critical care medicine 2017; 195(7):906-11. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 28 day mortality
|
Process
|
In-Patient
|
Fernando SM, Tran A, Taljaard M, Cheng W, Rochwerg B, Seely AJE, et al. Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection: A Systematic Review and Meta-analysis. Ann Intern Med 2018; 168(4):266-75. Medline
|
II
|
Neutral (Yellow)
|
Predicting sepsis
|
Process
|
ED-MD
|
Filbin MR., Thorsen JE., Lynch J., Gillingham TD., Pasakarnis CL., Capp R., et al. Challenges and Opportunities for Emergency Department Sepsis Screening at Triage. Scientific reports 2018; 8(1):11059. Medline
|
II
|
Neutral (Yellow)
|
Prediction of sepsis
|
Process
|
ED-MD
|
Haydar S., Spanier M., Weems P., Wood S., Strout T. Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis. Am J Emerg Med 2017; 35(11):1730-3. Medline
|
II
|
Neutral (Yellow)
|
Prediction of ICU admission
|
Process
|
|
Jouffroy R., Saade A., Carpentier A., Ellouze S., Philippe P., Idialisoa R., et al. Triage of Septic Patients Using qSOFA Criteria at the SAMU Regulation: A Retrospective Analysis. Prehospital Emergency Care 2018; 22(1):84-90. Medline
|
II
|
Neutral (Yellow)
|
Prediction of ICU admission
|
Process
|
PH-Paramedic
|
Jouffroy R., Saade A., Ellouze S., Carpentier A., Michaloux M., Carli P., et al. Prehospital triage of septic patients at the SAMU regulation: Comparison of qSOFA, MRST, MEWS and PRESEP scores. Am J Emerg Med 2018; 36(5):820-4. Medline
|
II
|
Neutral (Yellow)
|
Predictice value
|
Patient
|
Other
|
Melero-Guijarro L, Sanz-García A, Martín-Rodríguez F, et al. Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study. Front Med April 2023; 10:1149736. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 30-day mortality
|
Process
|
ED-MD
|
Oduncu AF, Kiyan GS, Yalçınlı S. Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department. Am J Emerg Med 2021; 48:54–9. Medline
|
II
|
Neutral (Yellow)
|
ICU admission with 48 hours
|
Process
|
PH-Paramedic
|
Silcock DJ, Corfield AR, Rooney KD, Staines H. Superior performance of National Early Warning Score compared with quick Sepsis-related Organ Failure Assessment Score in predicting adverse outcomes: a retrospective observational study of patients in the prehospital setting. European journal of emergency medicine: official journal of the European Society for Emergency Medicine 2018. Medline
|
II
|
Neutral (Yellow)
|
Prediction of ICU admission
|
Process
|
PH-Paramedic
|
Tusgul S., Carron PN., Yersin B., Calandra T., Dami F. Low sensitivity of qSOFA, SIRS criteria and sepsis definition to identify infected patients at risk of complication in the prehospital setting and at the emergency department triage. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2017; 25(1):108. Medline
|
II
|
Neutral (Yellow)
|
Prediction of in-hospital mortality (28 day)
|
Process
|
PH-MD & CCT
|
Vaittinada AP, Delay M, Avondo A, Duchateau FX, Nadiras P, Lapostolle F, et al. Prognostic value of prehospital quick sequential organ failure assessment score among patients with suspected infection. European journal of emergency medicine: official journal of the European Society for Emergency Medicine 2018. Medline
|
II
|
Opposes (Red)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Hwang SY, Jo IJ, Lee SU, Lee TR, Yoon H, Cha WC, et al. Low Accuracy of Positive qSOFA Criteria for Predicting 28-Day Mortality in Critically Ill Septic Patients During the Early Period After Emergency Department Presentation. Ann Emerg Med 2018; 71(1):1-9.e2. Medline
|
II
|
Opposes (Red)
|
Accuracy of scoring system for predicting ICU admission.
|
Process
|
ED-MD
|
Sabir L, Ramlakhan S, Goodacre S. Comparison of qSOFA and Hospital Early Warning Scores for prognosis in suspected sepsis in emergency department patients: a systematic review. Emerg Med J 2022; 39(4):284–94. Medline
|
III
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
PH-Paramedic
|
Barbara P., Graziano C., Caputo W., Litvak I., Battinelli D., Hahn B. The quick sequential organ failure assessment (qSOFA) identifies septic patients in the out-of-hospital setting. Am J Emerg Med 2018. Medline
|
III
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
ED-MD
|
Canet E., Taylor DM., Khor R., Krishnan V., Bellomo R. qSOFA as predictor of mortality and prolonged ICU admission in Emergency Department patients with suspected infection. J Crit Care 2018; 48:118-23. Medline
|
III
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
ED-MD
|
Chang SH., Yeh CC., Chen YA., Hsu CC., Chen JH., Chen WL., et al. Quick-SOFA score to predict mortality among geriatric patients with influenza in the emergency department. Medicine 2019; 98(23):e15966. Medline
|
III
|
Supportive (Green)
|
Prediction of in-hospital mortality
|
Process
|
PH-Paramedic
|
Koyama S., Yamaguchi Y., Gibo K., Nakayama I., Ueda S. Use of prehospital qSOFA in predicting in-hospital mortality in patients with suspected infection: A retrospective cohort study. PloS one 2019; 14(5):e0216560. Medline
|
III
|
Supportive (Green)
|
Sepsis identification
|
Process
|
PH-Paramedic
|
Lane DJ, Wunsch H, Saskin R, et al. Screening strategies to identify sepsis in the prehospital setting: a validation study. CMAJ. 2020;192(10):E230–E239. doi:10.1503/cmaj.190966 Medline
|
III
|
Neutral (Yellow)
|
Prediction of sepsis
|
Process
|
PH-Paramedic
|
Dorsett M., Kroll M., Smith CS., Asaro P., Liang SY., Moy HP. qSOFA Has Poor Sensitivity for Prehospital Identification of Severe Sepsis and Septic Shock. Prehosp Emerg Care 2017; 21(4):489-97. Medline
|
III
|
Opposes (Red)
|
1 year mortality
|
Process
|
Other
|
Martín-Rodríguez F, Enriquez de Salamanca Gambara R, Sanz-García A, et al. Comparison of seven prehospital early warning scores to predict long-term mortality: a prospective, multicenter, ambulance-based study. Eur J Emerg Med April 2023; 30(3):193-201. Medline
|
Identification tools-NEWS
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Accuracy of mortality prediction tools for sepsis.
|
Patient
|
ED-MD
|
Wang C, Xu R, Zeng Y, Zhao Y, Hu X. A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis. PLoS One 2022; 17(4):e0266755. Medline
|
II
|
Supportive (Green)
|
Detection of sepsis
|
Process
|
Other
|
Durr D, Niemi T, Despraz J, Tusgul S, Dami F, Akrour R, et al. National Early Warning Score (NEWS) Outperforms Quick Sepsis-Related Organ Failure (qSOFA) Score for Early Detection of Sepsis in the Emergency Department. Antibiot 2022; 11(11). Medline
|
II
|
Supportive (Green)
|
Predictive Value
|
Process
|
PH-Paramedic
|
Goodacre S, Sutton L, Thomas B, et al. Prehospital early warning scores for adults with suspected sepsis: retrospective diagnostic cohort study. Emerg Med J Sept 2023. Medline
|
II
|
Supportive (Green)
|
Accuracy
|
Process
|
ED-MD
|
Guarino M, Perna B, De Giorgi A, Gambuti E, Alfano F, et al. A 2-year retrospective analysis of the prognostic value of MqSOFA compared to lactate, NEWS and qSOFA in patients with sepsis. Infection 2022;50(4):941–8. Medline
|
II
|
Supportive (Green)
|
30 day and 90 day mortality from septic shock.
|
Patient
|
PH-MD & CCT
|
Jouffroy R, Négrello F, Limery J, et al. The prehospital NEW score to assess septic shock in-hospital, 30-day and 90-day mortality. BMC Infect Dis February 2024; 24(1):213. Medline
|
II
|
Supportive (Green)
|
Prediction of 30-day mortality from sepsis
|
Patient
|
PH-Paramedic
|
Lindskou TA, Ward LM, Søvsø MB, Mogensen ML, Christensen EF. Prehospital Early Warning Scores to Predict Mortality in Patients Using Ambulances. JAMA Netw Open August 2023; 6(8):e2328128. Medline
|
II
|
Supportive (Green)
|
Prediction of 1 year mortality
|
Process
|
PH-Paramedic
|
Martín-Rodríguez F, Enriquez de Salamanca Gambara R, Sanz-García A, et al. Comparison of seven prehospital early warning scores to predict long-term mortality: a prospective, multicenter, ambulance-based study. Eur J Emerg Med April 2023; 30(3):193-201. Medline
|
II
|
Supportive (Green)
|
Score agreement
|
Process
|
Other
|
Saberian P, Abdollahi A, Hasani-Sharamin P, Modaber M, Karimialavijeh E. Comparing the prehospital NEWS with in-hospital ESI in predicting 30-day severe outcomes in emergency patients. BMC Emerg Med. 2022; 22(1):42. Medline
|
II
|
Supportive (Green)
|
ICU Admission
|
Patient
|
ED-MD
|
Sabir L, Ramlakhan S, Goodacre S. Comparison of qSOFA and Hospital Early Warning Scores for prognosis in suspected sepsis in emergency department patients: a systematic review. Emerg Med J 2022; 39(4):284–94. Medline
|
II
|
Supportive (Green)
|
Detection
|
Process
|
In-Patient
|
Sivayoham N, Hussein AN, Shabbo L, Christie D. An observational cohort study of the performance of the REDS score compared to the SIRS criteria, NEWS2, CURB65, SOFA, MEDS and PIRO scores to risk-stratify emergency department suspected sepsis. Ann Med 2021; 53(1):1863–74. Medline
|
II
|
Supportive (Green)
|
Identification
|
Process
|
Other
|
Wallgren UM, Sjölin J, Järnbert-Pettersson H, Kurland L. Performance of NEWS2, RETTS, clinical judgment and the Predict Sepsis screening tools with respect to identification of sepsis among ambulance patients with suspected infection: a prospective cohort study. Scand J Trauma Resusc Emerg Med 2021; 29(1):144. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 30 day mortality
|
Process
|
PH-Paramedic
|
Guan G, Lee CMY, Begg S, Crombie A, Mnatzaganian G. The use of early warning system scores in prehospital and emergency department settings to predict clinical deterioration: A systematic review and meta-analysis. PLoS One 2022; 17(3):e0265559. Medline
|
II
|
Neutral (Yellow)
|
Diagnosis
|
Process
|
PH-Paramedic & MD
|
Melero-Guijarro L, Sanz-García A, Martín-Rodríguez F, et al. Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study. Front Med April 2023; 10:1149736. Medline
|
II
|
Neutral (Yellow)
|
Sensitivity and specificity for 30-day mortality
|
Process
|
ED-MD
|
Oduncu AF, Kiyan GS, Yalçınlı S. Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department. Am J Emerg Med 2021; 48:54–9. Medline
|
III
|
Supportive (Green)
|
Prediction of 48 hour repeat EMS visit
|
Patient
|
PH-Paramedic
|
Todd VF, Moylan M, Howie G, Swain A, Brett A, Smith T, et al. Predictive value of the New Zealand Early Warning Score for early mortality in low-acuity patients discharged at scene by paramedics: an observational study. BMJ Open 2022; 12(7):e058462. Medline
|
Identification tools-SIRS
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Sensitivity/specificity
|
Patient
|
ED-MD
|
Wang C, Xu R, Zeng Y, Zhao Y, Hu X. A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis. PLoS One 2022; 17(4):e0266755. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
ED-MD
|
April MD., Aguirre J., Tannenbaum LI., Moore T., Pingree A., Thaxton RE., et al. Sepsis Clinical Criteria in Emergency Department Patients Admitted to an Intensive Care Unit: An External Validation Study of Quick Sequential Organ Failure Assessment. J Emerg Med 2017; 52(5):622-31. Medline
|
II
|
Supportive (Green)
|
Prediction of severe sepsis
|
Process
|
ED-MD
|
Askim Ã., Moser F., Gustad LT., Stene H., Gundersen M., Ãsvold BO., et al. Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality - a prospective study of patients admitted with infection to the emergency department. Scandinavian journal of trauma, resuscitation and emergency medicine 2017; 25(1):56. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Brink A, Alsma J, Verdonschot RJCG, Rood PPM, Zietse R, Lingsma HF, et al. (2019) Predicting mortality in patients with suspected sepsis at the Emergency Department; A
retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLoS ONE
14(1): e0211133 Medline
|
II
|
Supportive (Green)
|
Prediction of 30-day mortality
|
Process
|
|
González del Castillo J, Julian-Jiménez A, González-Martínez F, Álvarez-Manzanares J, Piñera P, Navarro-Bustos C, et al. Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology 2017; 36(12):2361-9. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
ED-MD
|
Haydar S., Spanier M., Weems P., Wood S., Strout T. Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis. Am J Emerg Med 2017; 35(11):1730-3. Medline
|
II
|
Supportive (Green)
|
Accuracy of prehospital identification
|
Process
|
PH-Paramedic
|
Lane D., Ichelson R., Drennan I., Scales D. Prehospital management and identification of sepsis by emergency medical services: a systematic review. Emerg Med J 2016; 33:408–413. Medline
|
II
|
Supportive (Green)
|
Prediction of sepsis
|
Process
|
ED-MD
|
Mignot-Evers L, Raaijmakers V, Buunk G, Brouns S, Romano L, T van H, et al. Comparison of SIRS criteria and qSOFA score for identifying culture-positive sepsis in the emergency department: a prospective cross-sectional multicentre study. BMJ Open 2021; 11(6):e041024. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Oduncu AF, Kiyan GS, Yalçınlı S. Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department. Am J Emerg Med 2021; 48:54–9. Medline
|
II
|
Supportive (Green)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Saeed K., Wilson DC., Bloos F., Schuetz P., van der DY, Melander O., et al. The early identification of disease progression in patients with suspected infection presenting to the emergency department: a multi-centre derivation and validation study. Crit Care 2019; 23(1):40. Medline
|
II
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Tai HC., Yeh CC., Chen YA., Hsu CC., Chen JH., Chen WL., et al. Utilization of systemic inflammatory response syndrome criteria in predicting mortality among geriatric patients with influenza in the emergency department. BMC infectious diseases 2019; 19(1):639. Medline
|
II
|
Supportive (Green)
|
Prediction of 30 day mortality
|
Process
|
ED-MD
|
Williams JM., Greenslade JH., McKenzie JV., Chu K., Brown AFT., Lipman J. Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection. Chest 2017; 151(3):586-96. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Boulos D., Shehabi Y., Moghaddas JA., Birrell M., Choy A., Giang V., et al. Predictive value of quick Sepsis-Related Organ Failure Scores following sepsis-related Medical Emergency Team calls: a retrospective cohort study. Anaesth Intensive Care 2017; 45(6):688-94. Medline
|
II
|
Neutral (Yellow)
|
Prediction of 28 day mortality
|
Process
|
ED-MD
|
Churpek MM., Snyder A., Han X., Sokol S., Pettit N., Howell MD., et al. Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit. American journal of respiratory and critical care medicine 2017; 195(7):906-11. Medline
|
II
|
Neutral (Yellow)
|
Prediction of sepsis or septic shock
|
Process
|
In-Patient
|
Gilbert BW, Faires L, Meister A, Huffman J, Faber RK. Comparison of Sepsis-3 Criteria Versus SIRS Criteria in Screening Patients for Sepsis in the Emergency Department. Advanced emergency nursing journal 2018; 40(2):138-43. Medline
|
II
|
Neutral (Yellow)
|
Prediction of in-hospital mortality
|
Process
|
PH-Paramedic
|
Harada M., Takahashi T., Haga Y., Nishikawa T. Comparative study on quick sequential organ failure assessment, systemic inflammatory response syndrome and the shock index in prehospital emergency patients: single-site retrospective study. Acute medicine & surgery 2019; 6(2):131-7. Medline
|
II
|
Neutral (Yellow)
|
Prediction of ICU admission
|
Process
|
ED-MD
|
Jouffroy R., Saade A., Carpentier A., Ellouze S., Philippe P., Idialisoa R., et al. Triage of Septic Patients Using qSOFA Criteria at the SAMU Regulation: A Retrospective Analysis. Prehospital Emergency Care 2018; 22(1):84-90. Medline
|
II
|
Neutral (Yellow)
|
Predictive value to identify sepsis
|
Process
|
PH-Paramedic
|
Lane DJ, Wunsch H, Saskin R, et al. Screening strategies to identify sepsis in the prehospital setting: a validation study. CMAJ. 2020;192(10):E230–E239. doi:10.1503/cmaj.190966 Medline
|
II
|
Neutral (Yellow)
|
Prediction of critical illness
|
Process
|
ED-MD
|
Rodriguez RM, Greenwood JC, Nuckton TJ, Darger B, Shofer FS, Troeger D, et al. Comparison of qSOFA with current emergency department tools for screening of patients with sepsis for critical illness. Emergency medicine journal: EMJ 2018; 35(6):350-6. Medline
|
II
|
Neutral (Yellow)
|
Prediction of mortality
|
Process
|
In-Patient
|
Sivayoham N, Hussein AN, Shabbo L, Christie D. An observational cohort study of the performance of the REDS score compared to the SIRS criteria, NEWS2, CURB65, SOFA, MEDS and PIRO scores to risk-stratify emergency department suspected sepsis. Ann Med 2021; 53(1):1863–74. Medline
|
II
|
Neutral (Yellow)
|
Predictive value of various sepsis criteria
|
Process
|
ED-MD
|
Sparks R, Harada A, Chavada R, Trethewy C. Comparison of different sepsis scoring systems and pathways: qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in bacteraemic and non-bacteraemic patients presenting to the emergency department. BMC Infect Dis 2022; 22(1):76. Medline
|
II
|
Neutral (Yellow)
|
Prognostic accuracy
|
Process
|
ED-MD
|
Svendsen M, Steindal SA, Hamilton Larsen M, Trygg Solberg M. Comparison of the systematic Inflammatory response syndrome and the quick sequential organ failure assessment for prognostic accuracy in detecting sepsis in the emergency department: A systematic review. Int Emerg Nurs 2023; 66:101242. Medline
|
II
|
Neutral (Yellow)
|
Prediction of ICU admission
|
Process
|
PH-Paramedic
|
Tusgul S., Carron PN., Yersin B., Calandra T., Dami F. Low sensitivity of qSOFA, SIRS criteria and sepsis definition to identify infected patients at risk of complication in the prehospital setting and at the emergency department triage. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2017; 25(1):108. Medline
|
II
|
Neutral (Yellow)
|
30-day composite outcome (Mortality, Admission)
|
Patient
|
ED-MD
|
Yeşil O, Pekdemir M, Özturan İU, Doğan NÖ, Yaka E, et al. Performance of qSOFA, SIRS, and the qSOFA + SIRS combinations for predicting 30-day adverse outcomes in patients with suspected infection. Med Klin Intensivmed Notfmed Nov 2022; 117(8):623–9. Medline
|
III
|
Supportive (Green)
|
Prediction of mortality
|
Process
|
ED-MD
|
Asayama K., Aikawa N. Evaluation of systemic inflammatory response syndrome
criteria as a predictor of mortality in emergency patients transported by ambulance.
Keio J Med 1998;47:19–27. Medline
|
III
|
Supportive (Green)
|
Detection of sepsis
|
Process
|
PH-Paramedic
|
Smyth MA., Brace-McDonnell SJ., Perkins GD. Identification of adults with sepsis in the prehospital environment: a systematic review. BMJ Open 2016; 6(8):e011218-2016-011218. Medline
|
III
|
Neutral (Yellow)
|
Accuracy compared to bacterial cultures
|
Process
|
ED-MD
|
Minderhoud TC., Spruyt C., Huisman S., Oskam E., Schuit SCE., Levin MD. Microbiological outcomes and antibiotic overuse in Emergency Department patients with suspected sepsis. Neth J Med 2017; 75(5):196-203. Medline
|
III
|
Neutral (Yellow)
|
Detection of sepsis
|
Process
|
ED-MD
|
Morr M., Lukasz A., Rabig E., Pavenstdt H., Kampers P. Sepsis recognition in the emergency department - impact on quality of care and outcome? BMC Emergency Medicine 2017; 17(1):11. Medline
|
Point of Care Lactate
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
II
|
Supportive (Green)
|
Prediction of severe sepsis
|
Process
|
ED-MD
|
Contenti J., Corraze H., Lemoel F., Levraut J. Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients. Am J Emerg Med 2015; 33(2):167-72. Medline
|
II
|
Supportive (Green)
|
EMS identification of sepsis
|
Process
|
PH-Paramedic
|
Guerra WF., Mayfield TR., Meyers MS., Clouatre AE., Riccio JC. Early detection and treatment of patients with severe sepsis by prehospital personnel. J Emerg Med 2013; 44(6):1116-25. Medline
|
II
|
Supportive (Green)
|
Mortality prediction
|
Process
|
Other
|
Jouffroy R, Léguillier T, Gilbert B, Tourtier JP, Bloch-Laine E, Ecollan P, et al. Prehospital lactate clearance is associated with reduced mortality in patients with septic shock. Am J Emerg Med 2020. Medline
|
II
|
Supportive (Green)
|
Survival of all-cause sepsis at 3 and 28 days.
|
Patient
|
ED-MD
|
Julienne J, Douillet D, Mozziconacci MS, Callahan JC. Prognostic accuracy of using lactate in addition to the quick Sequential Organ Failure Assessment score and the National Early Warning Score for emergency department patients with suspected infection. Emerg Med J 2023; 40(1):28-35. Medline
|
II
|
Supportive (Green)
|
recognition and treatment of septic shock
|
Process
|
ICU
|
Larsen GY, Mecham N, Greenberg R. An emergency department septic shock protocol and care guideline for children initiated at triage. Pediatrics. 2011;127(6):e1585–e1592. Medline
|
II
|
Supportive (Green)
|
Mortality
|
Patient
|
ED-MD
|
Morris E, McCartney D, Lasserson D, Van den BA, Fisher R, Hayward G. Point-of-care lactate testing for sepsis at presentation to health care: a systematic review of patient outcomes. The British journal of general practice: the journal of the Royal College of General Practitioners 2017; 67(665):e859-70. Medline
|
II
|
Supportive (Green)
|
Prediction of 30- day Mortality or ICU admission
|
Process
|
ED-MD
|
Purcarea A., Bourgarit A., Sovaila A., Ghiura C., Diemunsch P., Andres E. Brief report: Serial capillary lactate measurement predict the evolution of early sepsis. J Med Life 2016; 9(1):74-8. Medline
|
II
|
Supportive (Green)
|
Time from ED triage to IV fluids and time to antibiotic administration
|
Process
|
ED-MD
|
Singer AJ, Taylor M, LeBlanc D, et al. ED bedside point-of-care lactate in patients with suspected sepsis is associated with reduced time to IV fluids and mortality. Am J Emerg Med. 2014;32(9):1120–1124. Medline
|
II
|
Supportive (Green)
|
mortality
|
Process
|
Other
|
Swan KL, Avard BJ, Keene T. The relationship between elevated prehospital point-of-care lactate measurements, intensive care unit admission, and mortality: A retrospective review of adult patients. Aust Crit Care 2018. Medline
|
II
|
Neutral (Yellow)
|
Absolute and relative diagnostic gains
|
Process
|
ED-MD
|
Báez AA, López O, Martínez MDP, Libell N, Cochón L, Nicolás JM. Clinical validation demonstrates concordance of qSOFA and POC lactate Bayesian model: Results from the ACDC Phase-2 program. Am J Emerg Med 2020. Medline
|
II
|
Neutral (Yellow)
|
Correlation to ED lactate
|
Process
|
PH-Paramedic
|
Boland LL., Hokanson JS., Fernstrom KM., Kinzy TG., Lick CJ., Satterlee PA., et al. Prehospital Lactate Measurement by Emergency Medical Services in Patients Meeting Sepsis Criteria. West J Emerg Med 2016; 17(5):648-55. Medline
|
II
|
Neutral (Yellow)
|
Agreement with serum lactate value
|
Process
|
PH-Paramedic
|
Swan KL., Keene T., Avard BJ. A 12-Month Clinical Audit Comparing Point-of-Care Lactate Measurements Tested by Paramedics with In-Hospital Serum Lactate Measurements. Prehosp Disaster Med 2018; 33(1):36-42. Medline
|
III
|
Supportive (Green)
|
Sepsis diagnosis
|
Process
|
ICU
|
Báez AA, López O, Martínez MDP, Libell N, Cochón L, Nicolás JM. Clinical validation demonstrates concordance of qSOFA and POC lactate Bayesian model: Results from the ACDC Phase-2 program. Am J Emerg Med 2020. Medline
|
III
|
Supportive (Green)
|
Feasibility
|
Process
|
PH-Paramedic
|
Walchok JG., Pirrallo RG., Furmanek D., Lutz M., Shope C., Giles B., et al. Paramedic-Initiated CMS Sepsis Core Measure Bundle Prior to Hospital Arrival: A Stepwise Approach. Prehosp Emerg Care 2016; 05:1-10. Medline
|
III
|
Neutral (Yellow)
|
Prediction of sepsis
|
Process
|
PH-Paramedic
|
Baez AA., Cochon L. Acute Care Diagnostics Collaboration: Assessment of a Bayesian clinical decision model integrating the Prehospital Sepsis Score and point-of-care lactate. Am J Emerg Med 2016; 34(2):193-6. Medline
|
III
|
Neutral (Yellow)
|
Predictive value of POC lactate for mortality
|
Patient
|
|
Mullen M, Cerri G, Murray R, et al. Use of point-of-care lactate in the prehospital aeromedical environment. Prehosp Disaster Med. 2014;29(2):200–203. Medline
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Magnusson C, Herlitz J, Axelsson C, et al. Added predictive value of prehospital measurement of point-of-care lactate in an adult general EMS population in Sweden: a multi-centre observational study. Scand J Trauma Resusc Emerg Med Aug 2024; 32(1):72. Medline
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Olander A, Frick L, Johansson J, Wibring K. The performance of screening tools and use of blood analyses in prehospital identification of sepsis patients and patients suitable for non-conveyance - an observational study. BMC Emerg Med 2024; 24(1):180. Medline
|
Prehospital Antibiotics
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Mortality
|
Patient
|
PH-Paramedic
|
Varney J, Motawea KR, Kandil OA, Hashim HT, Murry K, et al. Prehospital administration of broad-spectrum antibiotics for sepsis patients: A systematic review and meta-analysis. Heal Sci Rep 2022; 5(3):e582. Medline
|
I
|
Neutral (Yellow)
|
28-day mortality
|
Patient
|
PH-Paramedic
|
Alam N, Oskam E, Stassen PM, Exter PV, van de VP, Haak HR, et al. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. The Lancet Respiratory medicine 2018; 6(1):40-50. Medline
|
I
|
Neutral (Yellow)
|
Age-related determinant of reduced 28 day mortality from early, prehospital administration of antibiotics for sepsis.
|
Patient
|
ED-Paramedic & MD
|
Schinkel M, Paranjape K, Kundert J, Nannan Panday RS, Alam N, Nanayakkara PWB. Towards Understanding the Effective Use of Antibiotics for Sepsis. Chest 2021. Medline
|
I
|
Neutral (Yellow)
|
Mortality
|
Patient
|
ED-MD
|
Sterling SA., Miller WR., Pryor J., Puskarich MA., Jones AE. The impact of timing of antibiotics on outcomes in severe sepsis and septic shock: A systematic review and meta-analysis. Crit Care Med 2015; 43(9):1907-1915. Medline
|
II
|
Supportive (Green)
|
Adequate antibiotic coverage
|
Patient
|
ED-MD
|
Flaherty SK., Weber RL., Chase M., et al. Septic shock and adequacy of early empiric antibiotics in the emergency department. J Emerg Med 2014; 47(5):601-7. Medline
|
II
|
Supportive (Green)
|
Mortality
|
Patient
|
ED-MD
|
Gaieski DF., Mikkelsen ME., Band RA., Pines JM., Massone R., Furia FF., et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med 2010; 38(4):1045-53. Medline
|
II
|
Supportive (Green)
|
order-to-antibiotic time
|
Process
|
ED-MD
|
Hitti EA., Lewin JJ,3rd., Lopez J., Hansen J., Pipkin M., Itani T., et al. Improving door-to-antibiotic time in severely septic emergency department patients. J Emerg Med 2012; 42(4):462-9. Medline
|
II
|
Supportive (Green)
|
In hospital mortality
|
Patient
|
ED-MD
|
Im Y, Kang D, Ko RE, Lee YJ, Lim SY, et al. Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study. Crit Care 2022; 26(1):19. Medline
|
II
|
Supportive (Green)
|
Sepsis-related death or discharge
|
Patient
|
ED-MD
|
Jalili M., Barzegari H., Pourtabatabaei N., et al. Effect of door-to-antibiotic time on mortality of patients with sepsis in emergency department: A prospective cohort study. Acta Med Iran 2013; 51(7):454-60. Medline
|
II
|
Supportive (Green)
|
Mortality
|
Patient
|
ED-MD
|
Johnston AN., Park J., Doi SA., Sharman V., Clark J., Robinson J., et al. Effect of Immediate Administration of Antibiotics in Patients With Sepsis in Tertiary Care: A Systematic Review and Meta-analysis. Clin Ther 2017; 39(1):190-202. Medline
|
II
|
Supportive (Green)
|
30 day Mortality
|
Patient
|
PH-MD & CCT
|
Jouffroy R, Gilbert B, Hassan A, Tourtier JP, Bloch-Laine E, Ecollan P, et al. Adequacy of probabilistic prehospital antibiotic therapy for septic shock. Am J Emerg Med 2022; 53:80–5. Medline
|
II
|
Supportive (Green)
|
30 day mortality
|
Patient
|
PH-Paramedic & MD
|
Jouffroy R, Gilbert B, JP T, Bloch-Laine E, Ecollan P, Bounes V, Boularan J, Léguillier T, Gueye-Ngalgou, P, Vivien, B. Impact of Prehospital Antibiotic Therapy on Septic Shock Mortality. Prehosp Emerg Care 2021; 25(3): 317–24. Medline
|
II
|
Supportive (Green)
|
30 Day Mortality
|
Patient
|
PH-MD & CCT
|
Jouffroy R, Gilbert B, Tourtier JP, Bloch-Laine E, Ecollan P, Boularan J, Bounes V, Vivien B, Pressat-Laffouilhère T, Gueye P. Prehospital Bundle of Care Based on Antibiotic Therapy and Hemodynamic Optimization Is Associated With a 30-Day Mortality Decrease in Patients With Septic Shock. Crit Care Med 2022; 50(10):1440–8. Medline
|
II
|
Supportive (Green)
|
30 day mortality
|
Patient
|
Other
|
Jouffroy R, Holub M, Gilbert B, et al. Influence of antibiotic therapy with hemodynamic optimization on 30-day mortality among septic shock patients cared for in the prehospital setting. Am J Emerg Med Nov 2023; 76:48-54. Medline
|
II
|
Supportive (Green)
|
Mortality and LOS
|
Patient
|
PH-Paramedic
|
Martel T, Melmer MN, Leaman SM, et al. Prehospital antibiotics improve morbidity and 469 mortality of emergency medical service patients with sepsis. HCA Healthcare Journal of Medicine 2020; 470(1): 10. Medline
|
II
|
Supportive (Green)
|
28-day mortality
|
Patient
|
PH-Paramedic
|
Schinkel M, Paranjape K, Kundert J, Nannan Panday RS, Alam N, Nanayakkara PWB. Towards Understanding the Effective Use of Antibiotics for Sepsis. Chest 2021. Medline
|
II
|
Supportive (Green)
|
In-hospital Mortality
|
Patient
|
PH-Paramedic
|
Seymour C., Kahn J., Martin-Gill C., Callaway C., Yealy D., Scales D., Angus D., Delays From First Medical Contact to Antibiotic Administration for Sepsis. Critical Care Medicine 2017; 45(5):759–765. Medline
|
II
|
Supportive (Green)
|
Mortality (most common outcome of included studies)
|
Patient
|
ED-MD
|
Sherwin R, Winters ME, Vilke GM, Wardi G. Does Early and Appropriate Antibiotic Administration Improve Mortality in Emergency Department Patients with Severe Sepsis or Septic Shock? J Emerg Med 2017; 53(4):588-95. Medline
|
III
|
Supportive (Green)
|
Safety and feasibility
|
Patient
|
PH-Paramedic
|
Cunningham CT, Sanseverino A, Reznek M, et al. A pilot study of prehospital antibiotics for 479 severe sepsis. Academic Emergency Medicine 2022; 29: 231-233. Medline
|
III
|
Supportive (Green)
|
In-hospital mortality
|
Patient
|
ED-MD
|
Liu VX., Fielding-Singh V., Greene JD., Baker JM., Iwashyna TJ., Bhattacharya J., et al. The Timing of Early Antibiotics and Hospital Mortality in Sepsis. American Journal of Respiratory and Critical Care Medicine 2017; 196(7):856-63. Medline
|
III
|
Supportive (Green)
|
Survival
|
Patient
|
ED-MD
|
Siddiqui S., Salahuddin N., Raza A., Razzak J. How early do antibiotics have to be to impact mortality in severe sepsis? A prospective, observational study from an emergency department. J Ayub Med Coll Abbottabad 2009; 21(4):106-110. Medline
|
III
|
Supportive (Green)
|
Feasibility
|
Process
|
PH-Paramedic
|
Walchok JG., Pirrallo RG., Furmanek D., Lutz M., Shope C., Giles B., et al. Paramedic-Initiated CMS Sepsis Core Measure Bundle Prior to Hospital Arrival: A Stepwise Approach. Prehosp Emerg Care 2016; 05:1-10. Medline
|
III
|
Neutral (Yellow)
|
Mortality
|
Patient
|
ED-MD
|
Puskarich MA., Trzeciak S., Shapiro NI., et al. Association between timing of antibiotic administration and mortality from septic shock in patients treated with a quantitative resuscitation protocol. Crit Care Med 2011; 39(9):2066-71. Medline
|