Diagnostic Performance of Sepsis Scores in the Emergency Department: A Retrospective Study
"A Comparative Analysis of SIRS, SOFA, and qSOFA Scoring Systems for Early Sepsis Detection"
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Abstract
Abstract
Purpose: This study aimed to evaluate and compare the diagnostic performance of three commonly used sepsis scoring systems—SIRS, SOFA, and qSOFA—in patients presenting to the emergency department.
Design/Methodology/Approach: A retrospective diagnostic accuracy study was conducted using data from 800 adult patients who presented to a tertiary hospital emergency department with suspected infection between January 2023 and December 2024. Sepsis was defined according to Sepsis-3 criteria. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the ROC curve (AUC) were calculated for each scoring system.
Findings: SOFA demonstrated the highest diagnostic performance (AUC: 0.87), followed by qSOFA (AUC: 0.74) and SIRS (AUC: 0.71). SIRS had the highest sensitivity (84%) but lowest specificity (55%). qSOFA showed the highest specificity (88%) but lowest sensitivity (50%). SOFA achieved balanced sensitivity (80%) and specificity (78%). Subgroup analysis showed that SOFA was superior in predicting ICU admission and mortality, while qSOFA was effective for identifying critically ill patients.
Conclusion: Among the evaluated scoring systems, SOFA provides the best diagnostic accuracy for sepsis in the emergency setting. While qSOFA is useful for identifying high-risk patients quickly, its low sensitivity limits its standalone utility. SIRS remains highly sensitive but lacks specificity. These findings can support clinical decision-making and triage in emergency care.
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References
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