{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:31:42Z","timestamp":1782955902561,"version":"3.54.5"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Mochida Pharmaceuticals, Ltd"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sepsis definitions have evolved, but there is a lack of consensus over adoption of the most recent definition, Sepsis-3. We sought to compare Sepsis-2 and Sepsis-3 in the classification of patients with sepsis and mortality risk at 30 days.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used the following definitions: Sepsis-2 (\u22652 systemic inflammatory response syndrome criteria + infection), Sepsis-3 (prescreening by quick Sequential Organ Failure Assessment [qSOFA] of \u22652 of 3 criteria followed by the complete score change \u22652 + infection), and an amended Sepsis-3 definition, iqSOFA (qSOFA \u22652 + infection). We used \u03c7\u200a2 or Wilcoxon rank-sum tests, receiver-operator characteristic curves, and survival analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 176 patients (95% in an intensive care unit, 38.6% female, median age 61.4 years). Of 105 patients classified by Sepsis-2 as having sepsis, 80 had sepsis per Sepsis-3 or iqSOFA (kappa = 0.72; 95% confidence interval [CI], 0.62\u20130.82). Twenty-five (14.8%) died (20 of 100 with sepsis per Sepsis-2 [20%], and 20 of 77 [26.0%] with sepsis per Sepsis-3 or iqSOFA). Results for Sepsis-3 and iqSOFA were identical. The area under the curve of receiver-operator characteristic (ROC) curves for identifying those who died were 0.54 (95% CI, 0.41\u20130.68) for Sepsis-2, 0.84 (95% CI, 0.74\u20130.93) for Sepsis-3, and 0.69 (95% CI, 0.60\u20130.79) for iqSOFA (P &amp;lt; .01). Hazard ratios for death associated with sepsis were greatest for sepsis or septic shock per Sepsis-3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Sepsis-3 and iqSOFA were better at predicting death than Sepsis-2. Using the SOFA score might add little advantage compared with the simpler iqSOFA score.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofz271","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T08:35:23Z","timestamp":1559810123000},"source":"Crossref","is-referenced-by-count":17,"title":["Prospective Observational Study Comparing Sepsis-2 and Sepsis-3 Definitions in Predicting Mortality in Critically Ill Patients"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7867-393X","authenticated-orcid":false,"given":"Debra D","family":"Poutsiaka","sequence":"first","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura C","family":"Porto","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney A","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Hudcova","sequence":"additional","affiliation":[{"name":"Department of Surgical Critical Care, Lahey Hospital and Medical Center, Burlington, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Tybor","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Hadley","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9139-0857","authenticated-orcid":false,"given":"Shira","family":"Doron","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Reich","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R","family":"Snydman","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley A","family":"Nasraway","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,5]]},"reference":[{"key":"2020081004074246600_CIT0001","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/TA.0000000000001135","article-title":"The long-term burden of severe sepsis and septic shock: sepsis recidivism and organ dysfunction","volume":"81","author":"Guirgis","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"2020081004074246600_CIT0002","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.chest.2016.07.010","article-title":"Estimating ten-year trends in septic shock incidence and mortality in United States Academic Medical Centers using clinical data","volume":"151","author":"Kadri","year":"2017","journal-title":"Chest"},{"key":"2020081004074246600_CIT0003","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1001\/jama.2016.0288","article-title":"Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Seymour","year":"2016","journal-title":"JAMA"},{"key":"2020081004074246600_CIT0004","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1097\/CCM.0000000000001658","article-title":"Long-term quality of life among survivors of severe sepsis: analyses of two international trials","volume":"44","author":"Yende","year":"2016","journal-title":"Crit Care Med"},{"key":"2020081004074246600_CIT0005","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1097\/CCM.0000000000000330","article-title":"Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program","volume":"42","author":"Ferrer","year":"2014","journal-title":"Crit Care Med"},{"key":"2020081004074246600_CIT0006","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1703058","article-title":"Time to treatment and mortality during mandated emergency care for sepsis","volume":"376","author":"Seymour","year":"2017","journal-title":"N Engl J Med"},{"key":"2020081004074246600_CIT0007","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1378\/chest.101.6.1644","article-title":"Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP\/SCCM Consensus Conference Committee. American College of Chest Physicians\/Society of Critical Care Medicine","volume":"101","author":"Bone","year":"1992","journal-title":"Chest"},{"key":"2020081004074246600_CIT0008","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1001\/jama.2016.0289","article-title":"Developing a new definition and assessing new clinical criteria for septic shock: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Shankar-Hari","year":"2016","journal-title":"JAMA"},{"key":"2020081004074246600_CIT0009","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"2020081004074246600_CIT0010","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1097\/01.CCM.0000168253.91200.83","article-title":"The International Sepsis Forum Consensus Conference on definitions of infection in the intensive care unit","volume":"33","author":"Calandra","year":"2005","journal-title":"Crit Care Med"},{"key":"2020081004074246600_CIT0011","author":"Centers for Disease Control, Network NHS"},{"key":"2020081004074246600_CIT0012","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1001\/jama.2016.20328","article-title":"Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit","volume":"317","author":"Raith","year":"2017","journal-title":"JAMA"},{"key":"2020081004074246600_CIT0013","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.chest.2016.01.003","article-title":"Nonlinear imputation of Pao2\/Fio2 from Spo2\/Fio2 among patients with acute respiratory distress syndrome","volume":"150","author":"Brown","year":"2016","journal-title":"Chest"},{"key":"2020081004074246600_CIT0014","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.chest.2016.10.057","article-title":"Systemic inflammatory response syndrome, quick sequential organ function assessment, and organ dysfunction: insights from a prospective database of ED patients with infection","volume":"151","author":"Williams","year":"2017","journal-title":"Chest"},{"key":"2020081004074246600_CIT0015","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1001\/jama.2016.20329","article-title":"Prognostic accuracy of Sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department","volume":"317","author":"Freund","year":"2017","journal-title":"JAMA"},{"key":"2020081004074246600_CIT0016","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.annemergmed.2017.01.008","article-title":"An emergency department validation of the SEP-3 sepsis and septic shock definitions and comparison with 1992 consensus definitions","volume":"70","author":"Henning","year":"2017","journal-title":"Ann Emerg Med"},{"key":"2020081004074246600_CIT0017","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/jama.2016.19684","article-title":"qSOFA for identifying sepsis among patients with infection","volume":"317","author":"Lamontagne","year":"2017","journal-title":"JAMA"},{"key":"2020081004074246600_CIT0018","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1164\/rccm.201604-0854OC","article-title":"Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit","volume":"195","author":"Churpek","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2020081004074246600_CIT0019","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1097\/CCM.0000000000002512","article-title":"The impact of the sepsis-3 septic shock definition on previously defined septic shock patients","volume":"45","author":"Sterling","year":"2017","journal-title":"Crit Care Med"},{"key":"2020081004074246600_CIT0020","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/CCM.0000000000002778","article-title":"Should we manage all septic patients based on a single definition? An alternative approach","volume":"46","author":"Kalil","year":"2018","journal-title":"Crit Care Med"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofz271\/28771220\/ofz271.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/6\/7\/ofz271\/33589911\/ofz271.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/6\/7\/ofz271\/33589911\/ofz271.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T08:20:16Z","timestamp":1597047616000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofz271\/5511918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,5]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofz271","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,7]]},"published":{"date-parts":[[2019,6,5]]},"article-number":"ofz271"}}