A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis

Can Wang; Rufu Xu; Yuerong Zeng; Yu Zhao; Xuelian Hu

doi:10.1371/journal.pone.0266755

A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis

PLoS One. 2022 Apr 15;17(4):e0266755. doi: 10.1371/journal.pone.0266755. eCollection 2022.

Authors

Can Wang^{1

2}, Rufu Xu¹, Yuerong Zeng^{1

2}, Yu Zhao², Xuelian Hu¹

Affiliations

¹ Department of Pharmacy, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
² Department of Pharmacy, University Town Hospital Affiliated of Chongqing Medical University, Chongqing, China.

Abstract

Objective: To identify and compare prognostic accuracy of quick Sequential Organ Failure Assessment (qSOFA) score, Systemic Inflammatory Response Syndrome (SIRS) criteria, and National Early Warning Score (NEWS) to predict mortality in patients with suspected sepsis.

Methods: This meta-analysis followed accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched PubMed, EMBASE, Web of Science, and the Cochrane Library databases from establishment of the database to November 29, 2021. The pooled sensitivity and specificity with 95% CIs were calculated using a bivariate random-effects model (BRM). Hierarchical summary receiver operating characteristic (HSROC) curves were generated to assess the overall prognostic accuracy.

Results: Data of 62338 patients from 26 studies were included in this meta-analysis. qSOFA had the highest specificity and the lowest sensitivity with a specificity of 0.82 (95% CI: 0.76-0.86) and a sensitivity of 0.46 (95% CI: 0.39-0.53). SIRS had the highest sensitivity and the lowest specificity with a sensitivity of 0.82 (95% CI: 0.78-0.85) and a specificity 0.24 (95% CI: 0.19-0.29). NEWS had both an intermediate sensitivity and specificity with a sensitivity of 0.73 (95% CI: 0.63-0.81) and a specificity 0.52 (95% CI: 0.39-0.65). qSOFA showed higher overall prognostic accuracy than SIRS and NEWS by comparing HSROC curves.

Conclusions: Among qSOFA, SIRS and NEWS, qSOFA showed higher overall prognostic accuracy than SIRS and NEWS. However, no scoring system has both high sensitivity and specificity for predicting the accuracy of mortality in patients with suspected sepsis.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Emergency Service, Hospital
Hospital Mortality
Humans
Organ Dysfunction Scores
Prognosis
ROC Curve
Retrospective Studies
Sepsis* / diagnosis
Systemic Inflammatory Response Syndrome* / diagnosis

Grants and funding

The institutes which provided us funding were: The Chongqing Health Committee (No. 2021MSXM255); The Army Medical University (No. 2019XLC 3035). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.