Rahuldeb Sarkar in Lancet Global Health
Full text here https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00304-7/fulltext
Sepsis, or dysregulated host immune response to infection, is a major killer worldwide, responsible for nearly 20% of all deaths globally. Therefore, early identification of patients at increased risk of developing sepsis is important for initiation of appropriate care pathways, and to reduce preventable deaths. However, this identification process requires additional resource allocation, which even high-income countries (HICs) struggle with and contemplate upon. Efficient prediction tools like the Sequential Organ Failure Assessment (SOFA) score, involving multiple laboratory parameters, have consistently shown high precision, but are challenging to implement in low-income and middle-income countries (LMICs) due to logistical and operational issues. The Sepsis-3 task force showed the quick SOFA (qSOFA) score to have good predictive validity in identifying patients with suspected infection at high risk of mortality in patients outside intensive care units in a HIC setting. This has been subsequently corroborated in LMIC settings. However, the most recent Surviving Sepsis Guideline strongly recommends against using qSOFA as a single screening tool for sepsis because of low sensitivity. Therefore, the search for a simplistic effective tool for resource-limited settings continues.