Unpacking Prevalence and Dichotomy in Quick Sequential Organ Failure Assessment and Systemic Inflammatory Response...

Area of Science:

• Critical Care Medicine
• Medical Informatics
• Public Health

Background:

• Sepsis incidence is rising in US ICUs, increasing morbidity, mortality, and costs.
• The sepsis-3 definition (qSOFA) has prompted research into its relation with the previous sepsis-2 (SIRS) definition.
• Understanding these definitions is crucial for effective sepsis management and resource allocation.

Purpose of the Study:

• Identify the most prevalent criteria for sepsis-3 (qSOFA) and sepsis-2 (SIRS).
• Determine the most common sepsis scenarios in the ICU for both definitions.
• Investigate the relationship (multicollinearity or dichotomy) between qSOFA and SIRS predictors.

Main Methods:

• Observational study using MIMIC-III database (2001-2012).
• Analysis of qSOFA and SIRS parameters for ICU patients undergoing sepsis screening.
• Multiblind Delphi method used for data handling decisions.

Main Results:

• Altered mental status was the most prevalent sepsis-3 criterion (59.28%).
• High white blood cell count was the most prevalent sepsis-2 criterion (53.12%).
• The most prevalent sepsis-3 scenario involved high respiratory rate and altered mental status (28.19%).
• The most prevalent sepsis-2 scenario included tachypnea, high heart rate, and high white blood cell count (12.32%).
• No significant linear correlation (multicollinearity) was found between qSOFA and SIRS parameters, suggesting dichotomy.

Conclusions:

• Prevalence quantification of sepsis-3 (qSOFA) versus sepsis-2 (SIRS) criteria offers insights for ICU treatment and hospital resource allocation.
• The identified dichotomy between qSOFA and SIRS parameters has implications for sepsis management strategies.
• Data-driven findings support the design of multiparameter intelligent sepsis prediction systems for ICUs.