{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:07:56Z","timestamp":1765807676683,"version":"3.48.0"},"reference-count":27,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,17]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to examine the validity of the quick Sequential Organ Failure Assessment (qSOFA) score for mortality and bacteraemia risk assessment in Japanese haemodialysis patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a retrospective multicentre cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The six participating hospitals are tertiary-care institutions that receive patients on an emergency basis and provide primary, secondary and tertiary care. The other participating hospital is a secondary-care institution that receives patients on an emergency basis and provides both primary and secondary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>This study included haemodialysis outpatients admitted for bacteraemia suspicion, who had blood drawn for cultures within 48\u2009hours of their initial admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome measure was overall in-hospital mortality. Secondary outcomes included 28-day in-hospital mortality and the incidence of bacteraemia diagnosed based on blood culture findings. The discrimination, calibration and test performance of the qSOFA score were assessed. Missing data were handled using multiple imputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 507 haemodialysis patients admitted with bacteraemia suspicion between August 2011 and July 2013, the overall in-hospital mortality was 14.6% (74\/507), the 28-day in-hospital mortality was 11.1% (56\/507) and the incidence of bacteraemia, defined as a positive blood culture, was 13.4% (68\/507). For predicting in-hospital mortality among haemodialysis patients, the area under the receiver operating characteristic curve was 0.61 (95% CI 0.56\u20130.67) for a qSOFA score \u22652. The Hosmer-Lemeshow \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      statistics for the qSOFA score as a predictor of overall and 28-day in-hospital mortality were 5.72 (p=0.02) and 7.40 (p&lt;0.01), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>On external validation, the qSOFA score exhibited low diagnostic accuracy and miscalibration for in-hospital mortality and bacteraemia among haemodialysis patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028856","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T05:35:46Z","timestamp":1562909746000},"page":"e028856","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["External validation of the quick Sequential Organ Failure Assessment score for mortality and bacteraemia risk evaluation in Japanese patients undergoing haemodialysis: a retrospective multicentre cohort study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7365-7685","authenticated-orcid":false,"given":"Hiroki","family":"Nishiwaki","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan"},{"name":"Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan"},{"name":"Research Administration Center (SURAC), Showa University, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Nephrology\/Clinical Research Support Office, Iizuka Hospital, Iizuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan"},{"name":"Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan"},{"name":"Research Administration Center (SURAC), Showa University, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Sasai","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroo","family":"Kawarazaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Inagi Municipal Hospital, Inagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Minatoguchi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Chubu Rosai Hospital, Nagoya, Japan"},{"name":"Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Kawasaki Municipal Tama Hospital, Kawasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Koitabashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Saint Marianna University School of Medicine, Kawasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaya","family":"Ozeki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Nagoya University Graduate School of Medicine, 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