Sepsis Tanı Kriterlerinin Karşılaştırılması

Abstract

Sarıer M., Assessing Clinical Criteria for Sepsis. Hacettepe University Faculty of Medicine, Thesis of Emergency Medicine, Ankara 2018. There is no gold standard test or score to be used in the diagnosis of sepsis and the prognosis of the sepsis. The aim of this study is to compare commonly used scorings. Between May 1, 2016 and April 30, 2017, 100 patients who were admitted to the Hacettepe University Medical Faculty Adult Emergency Department, who were taking antibiotics for sepsis and who received at least two cultures and were over 18 years of age were included in the study. According to the criteria for death or hospitalization in intensive care unit for three days or more, 51 patients were accepted as sepsis. The mean age of the patients with sepsis diagnosis was 66.71 and the others‟ mean age was 64.16. No statistically significant difference was found. Male gender was more common in patients with sepsis (66%). There was no significant difference between procalcitonin, lactate levels and mean duration of antibiotic treatment between patients with and without sepsis. In both groups the most frequent source of infection was pneumonia, the second one was the urinary system. Reproduction was detected in 50 patients, at least one any culture of body liquid or blood culture. The length of stay in emergency department was longer in patients with sepsis than in those without sepsis. There was no relationship between the length of stay in emergency department of the patients and the outcome of death. When the area under the curve was examined for SIRS, SOFA, qSOFA, MEWS≥5, MEWS≥6, and MEWS≥7 scores, the best score as the diagnostic test for sepsis was qSOFA. The scores with the highest 3 values were found as qSOFA, MEWS≥6 and SOFA, respectively. SIRS was the lowest diagnostic score. MEWS≥6 is may be an alternative to qSOFA for ease of use. Although similar results have been obtained in SOFA, many laboratory parameters prevent early and easy use of the emergency care department.