[A multicenter confirmatory study about precision and practicability of Sepsis-3]

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Clinical Diagnostics

Background:

• Sepsis diagnosis has evolved with criteria like Sepsis-2 and Sepsis-3.
• Clinical validation and generalization of Sepsis-3 are crucial for patient care.
• Understanding the diagnostic accuracy and prognostic value of different sepsis criteria is essential.

Purpose of the Study:

• To clinically validate the precision of the Sepsis-3 diagnostic criteria.
• To guide and generalize the clinical application of Sepsis-3.
• To compare diagnostic accuracy and patient outcomes between Sepsis-2 and Sepsis-3.

Main Methods:

• A multicenter retrospective observational study involving 1,423 ICU patients.
• Screening and comparison of patients meeting Sepsis-2 and Sepsis-3 criteria.
• Logistic regression and ROC curve analysis to assess diagnostic factors and predictive values (SIRS, qSOFA, SOFA).

Main Results:

• 363 patients met Sepsis-2 criteria, and 329 met Sepsis-3 criteria.
• Sepsis-3 patients exhibited higher APACHE II scores, longer ICU stays, and worse 28-day mortality compared to the Sepsis-3 exclude group.
• The prognostic value for mortality increased from SIRS to qSOFA to SOFA (AUC 0.567, 0.597, 0.683), with qSOFA and SOFA showing significant predictive value.

Conclusions:

• Sepsis-3 criteria identify patients with more organ failure and higher mortality risk, demonstrating higher diagnostic specificity than Sepsis-2.
• While Sepsis-3 shows improved prediction, further refinement is necessary for optimal clinical application.
• The study highlights the importance of qSOFA in sepsis prediction, even when used alongside SOFA.