Criterios QSOFA y nivel de lactato como predictores de necesidad de cuidados críticos en pacientes con sospecha de sepsis en el área de emergencia del Hospital Vicente Corral Moscoso, Cuenca-2020

Abstract

Background: Sepsis and septic shock are considered a medical emergency, which brings seriousdeleterious effects on the health of those who suffer from it. There are criteria to predict severity in an emergency room such as qSOFA and lactate levels; however, there are still controversies regarding its role as a predictor for admission to the Intensive Care Unit. Objective: to determine if the qSOFA criteria and lactate levels are good predictors of the need for Critical Care in patients with suspected Sepsis in the Emergency Department of the Vicente Corral Moscoso Hospital, Cuenca-2020. Methodology: validation of diagnostic tests, 175 participants were included, determining the capacity of the qSOFA score and lactate levels as predictors of the need for Critical Care in patients with suspected sepsis. Sensitivity, specificity, PPV, NPV and ROC curve were assessed.All bioethical procedures were applied. Results: A positive qSOFA (≥ 2) had a sensitivity of 72.8%, specificity of 34.0%, PPV of 48.8%,NPV of 59.3%. The lactate level, with a cut-off point of ≥ 2 mmol / L, obtained a sensitivity of 60.5%, specificity of 50.3%, PPV of 53.3%, NPV of 61.4%. The lactate level with a higher Youden Index (IY = 0.28) was ≥ 1.69 mg / dl with a sensitivity of 82.7%, specificity of 45.7%, PPV of 56.8%, NPV of 75.4% and AUC of 0.648. Conclusions: qSOFA and lactate levels in patients with suspected sepsis have limited value in predicting the probability of needing critical care.