Quick sequential organ failure assessment score found to be ineffective for diagnosing sepsis and septic shock in dogs
From
VetSurgeon.org
A new study published in the Journal of Small Animal Practice (JSAP) has concluded that the quick sequential organ failure assessment is poor indicator of mortality, has a low sensitivity to to detect canine patients with severe sepsis and septic shock, and should not be used alone when screening for sepsis.
The study “Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock1” reviewed electronic records from dogs that presented through the veterinary medical teaching hospital emergency service between January 2010 and December 2019 using the search terms “sepsis” or “septic”.
The quick sequential organ failure score was calculated by evaluating respiratory rate (>22 breaths per minute), arterial systolic blood pressure (≤100mmHg) and altered mentation.
Forty-five dogs with severe sepsis and septic shock and 45 dogs with non-infectious systemic inflammatory response syndrome were included in the final analysis.
It was found that the quick sequential organ failure assessment score provided poor discrimination between survivors and non-survivors for dogs with severe sepsis and septic shock.
In addition, the quick sequential organ failure score demonstrated a poor sensitivity and fair specificity to detect this population of canine patients.
The authors say that previous studies on quick sequential organ failure score have provided conflicting results, but that this may just be due to the inherent heterogeneity of the population.
Considering the results of this study, it may not be possible to identify a single scoring system that serves the purpose that quick sequential organ failure assessment is intended for.
Nicola Di Girolamo, Editor of the JSAP said: “The results of this study have strong clinical implications.
"The JSAP values studies with negative findings such as this one, as much as studies with positive findings.
"The fact that a diagnostic tool or a treatment does not reach the desired objective, should not hinder publication of methodologically sound research”