Comparing Quick Sequential Organ Failure Assessment Scores to End-tidal Carbon Dioxide as Mortality Predictors in Prehospital Patients with Suspected Sepsis

West J Emerg Med. 2018 May;19(3):446-451. doi: 10.5811/westjem.2018.1.35607. Epub 2018 Mar 13.

Abstract

Introduction: Early identification of sepsis significantly improves outcomes, suggesting a role for prehospital screening. An end-tidal carbon dioxide (ETCO2) value ≤ 25 mmHg predicts mortality and severe sepsis when used as part of a prehospital screening tool. Recently, the Quick Sequential Organ Failure Assessment (qSOFA) score was also derived as a tool for predicting poor outcomes in potentially septic patients.

Methods: We conducted a retrospective cohort study among patients transported by emergency medical services to compare the use of ETCO2 ≤ 25 mmHg with qSOFA score of ≥ 2 as a predictor of mortality or diagnosis of severe sepsis in prehospital patients with suspected sepsis.

Results: By comparison of receiver operator characteristic curves, ETCO2 had a higher discriminatory power to predict mortality, sepsis, and severe sepsis than qSOFA.

Conclusion: Both non-invasive measures were easily obtainable by prehospital personnel, with ETCO2 performing slightly better as an outcome predictor.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biomarkers / metabolism
  • Carbon Dioxide / metabolism*
  • Emergency Medical Services / methods*
  • Female
  • Humans
  • Male
  • Organ Dysfunction Scores*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sepsis / diagnosis*
  • Sepsis / metabolism
  • Sepsis / mortality*

Substances

  • Biomarkers
  • Carbon Dioxide