{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:36:58Z","timestamp":1790037418087,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early identification of patients with sepsis at risk of deterioration is essential to reduce mortality. The quick Sequential Organ Failure Assessment (qSOFA) score is a widely used bedside tool but has limited sensitivity. Emerging evidence suggests that combining qSOFA with lactate levels (qSOFA\u2010lactate) may improve predictive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the prognostic accuracy of the qSOFA\u2010lactate score in predicting 30\u2010day all\u2010cause mortality among hospitalised patients with sepsis and to assess its applicability in nurse\u2010led clinical assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A prospective observational study was conducted at the Intermediate Care Unit of Alto Vicentino Hospital in Santorso, from 1 October 2022 to 1 February 2025. Consecutive adult patients admitted from the emergency department to the Intermediate Care Unit (IMCU) with a diagnosis of sepsis were enrolled. Clinical data, vital signs and laboratory values were collected at admission. The qSOFA\u2010lactate score was calculated by summing qSOFA points and lactate level categories. Predictive performance was analysed using ROC curves, net reclassification improvement (NRI) and decision curve analysis (DCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 370 patients were included, with a 30\u2010day mortality rate of 16.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959). qSOFA\u2010lactate showed modestly higher discrimination (AUROC: 0.724) than qSOFA (AUROC: 0.706) and lactate alone (AUROC: 0.671;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). Risk reclassification was directionally favourable (NRI 0.114; 27 net correct reclassifications, 7.3 per 100 patients). Decision curve analysis showed higher net benefit for qSOFA\u2010lactate across 10%\u201325% decision thresholds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>qSOFA\u2010lactate modestly improves risk stratification as an adjunct to qSOFA without adding bedside complexity. It can slightly improve early decision\u2010making (reclassification and net benefit) and may support timely intervention in acute care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>The qSOFA\u2010lactate score is a practical, nurse\u2010friendly adjunct that can strengthen early sepsis assessment and clinical decision\u2010making. Its integration into standard nursing evaluations could facilitate rapid recognition and appropriate care escalation for high\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70386","type":"journal-article","created":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T05:18:27Z","timestamp":1770527907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>qSOFA<\/scp>\n                    and Lactate for Nurse\u2010Led Identification of High\u2010Risk Septic Patients: A Prospective Observational Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4204-8884","authenticated-orcid":false,"given":"Arian","family":"Zaboli","sequence":"first","affiliation":[{"name":"Health Professions Management, South Tyrolean Health Authority (SABES\u2010ASDAA)  Bolzano 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Santorso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Genco","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Intermediate Care Unit Hospital Alto Vicentino (AULSS\u20107)  Santorso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Fulghesu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Intermediate Care Unit Hospital Alto Vicentino (AULSS\u20107)  Santorso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Carlana","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Intermediate Care Unit Hospital Alto Vicentino (AULSS\u20107)  Santorso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Bertoncello","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Intermediate Care Unit Hospital Alto Vicentino 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