Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
Sepsis is the most expensive cause of hospitalization.
The systemic inflammatory respiratory syndrome (SIRS) criteria have poor sensitivity and specificity for identifying sepsis.
Sepsis-3 proposed a new bedside assessment tool called qSOFA (quick systemic organ failure assessment). qSOFA has 3 components: (1) respiratory rate > 22 breaths/min, (2) altered mental status, and (3) systemic blood pressure (SBP) ≤ 100 mm Hg. Having 2 or more criteria in the correct clinical setting is suggestive of sepsis.
Mouncey PR, Osborn TM, Power GS, et al. Trial of early, goal-directed resuscitation for septic shock. N Engl J Med. 2015;372(14):1301-1311. (Randomized clinical trial; 1260 patients) DOI: http://dx.doi.org/10.1056/NEJMoa1500896
Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third International Consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):762-774. (Retrospective; 706,399 patients) DOI: http://dx.doi.org/10.1001/jama.2016.0288
Pandharipande PP, Shintani AK, Hagerman HE, et al. Derivation and validation of SpO2/FiO2 ratio to impute for PaO2/FiO2 ratio in the respiratory component of the sequential or-gan failure assessment score. Crit Care Med. 2009;37(4):1317-1321. (Prospective observational; 2986 patients) DOI: http://dx.doi.org/10.1097/CCM.0b013e31819cefa9
Jones AE, Shapiro NI, Trzeciak S, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010;303(8):739- 746. (Clinical trial; 300 patients) DOI: http://dx.doi.org/10.1001/jama.2010.158
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):2066-2071. (Clinical trial; 291 patients) DOI: http://dx.doi.org/10.1097/CCM.0b013e31821e87ab