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Algarni AM, Alfaifi MS, Al Bshabshe AA, Omair OM, Alsultan MA, Alzahrani HM, Alali HE, Alsabaani AA, Alqarni AM, Alghanem SA, Al Mufareh BS, Almemari AM, Sindi AA, Ozturan IU, Alhadhira AA, Shujaa AS, Alotaibi AH, Awladthani MM, Alsaad AA, Almarshed AA, AlQahtani AM, Harris TR, Alyahya BA, Assiri SA, Abuzeyad FH, Kazim SN, Al-Fares AA, Almazroua FY, Marzook NT, Basri AA, Elsafti AM, Alalshaikh AS, Özturan CA, Alawad YI, AlOmari A, Alkhateeb MA, Farooq MM, AlMutairi LA, Alasfour MM, Al Haber MI, Umar UKA, Bokhary NH, Alqahtani SF, Almutairi A, Alyahya HF, Alzahrani WS, Alsalmi F, Omair AM, Alasmari FM, Alfifi SY, Al-Nujimi MS, Foroutan F. Prognostic accuracy of qSOFA score, SIRS criteria, and EWSs for in-hospital mortality among adult patients presenting with suspected infection to the emergency department (PASSEM) Multicenter prospective external validation cohort study protocol. PLoS One 2024; 19:e0281208. [PMID: 38232095 PMCID: PMC10793907 DOI: 10.1371/journal.pone.0281208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Early identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ dysfunction. Screening tools using these parameters can help identify the condition, such as SIRS, quick SOFA (qSOFA), National Early Warning Score (NEWS), or Modified Early Warning Score (MEWS). We aim to externally validate qSOFA, SIRS, and NEWS/NEWS2/MEWS for in-hospital mortality among adult patients with suspected infection who presenting to the emergency department. METHODS AND ANALYSIS PASSEM study is an international prospective external validation cohort study. For 9 months, each participating center will recruit consecutive adult patients who visited the emergency departments with suspected infection and are planned for hospitalization. We will collect patients' demographics, vital signs measured in the triage, initial white blood cell count, and variables required to calculate Charlson Comorbidities Index; and follow patients for 90 days since their inclusion in the study. The primary outcome will be 30-days in-hospital mortality. The secondary outcome will be intensive care unit (ICU) admission, prolonged stay in the ICU (i.e., ≥72 hours), and 30- as well as 90-days all-cause mortality. The study started in December 2021 and planned to enroll 2851 patients to reach 200 in-hospital death. The sample size is adaptive and will be adjusted based on prespecified consecutive interim analyses. DISCUSSION PASSEM study will be the first international multicenter prospective cohort study that designated to externally validate qSOFA score, SIRS criteria, and EWSs for in-hospital mortality among adult patients with suspected infection presenting to the ED in the Middle East region. STUDY REGISTRATION The study is registered at ClinicalTrials.gov (NCT05172479).
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Affiliation(s)
| | - Musa S. Alfaifi
- Emergency Medicine Department, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | | | - Othman M. Omair
- Emergency Medicine Department, Aseer Central Hospital, Abha, Saudi Arabia
| | | | | | - Hadi E. Alali
- Emergency Medicine Department, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | | | - Ali M. Alqarni
- Radiology Department, Prince Mashary Bin Saud Hospital, Belgraishi, Saudi Arabia
| | - Salah A. Alghanem
- Emergency Medicine Department, Bahrain Defence Force Hospital, Al Riffa, Bahrain
| | - Bandar S. Al Mufareh
- Emergency Medicine Department, Royal Commission Hospital in Jubail, Jubail, Saudi Arabia
| | - Ayesha M. Almemari
- Emergency Medicine Department, Shaikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | - Ibrahim U. Ozturan
- Kocaeli University, Faculty of Medicine, Emergency Medicine Department, Kocaeli, Turkey
| | - Abdullah A. Alhadhira
- Emergency Medicine Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Asaad S. Shujaa
- Emergency Medicine Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Abdullah H. Alotaibi
- Emergency Medicine Department, King Abdullah University Hospital, Riyadh, Saudi Arabia
| | | | - Ahmed A. Alsaad
- Emergency Medicine Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | | | - Tim R. Harris
- Emergency Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Saad A. Assiri
- Emergency Medicine Department, Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Feras H. Abuzeyad
- Emergency Medicine Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Sara N. Kazim
- Emergency Medicine Department, Rashid Hospital, Dubai, United Arab Emirates
| | | | | | - Naif T. Marzook
- Emergency Medicine Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdullah A. Basri
- Emergency Medicine Department, Bahrain Defence Force Hospital, Al Riffa, Bahrain
| | | | | | - Cansu A. Özturan
- Emergency Medicine Department, Gölcük Necati Çelik State Hospital, Gölcük, Kocaeli, Turkey
| | - Yousef I. Alawad
- Emergency Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Awad AlOmari
- Critical Care Department, Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Malek A. Alkhateeb
- Emergency Medicine Department, Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Moonis M. Farooq
- Emergency Medicine Department, King Hamad University Hospital, Muharraq, Bahrain
| | | | | | - Mohammad I. Al Haber
- Emergency Medicine Department, Shaikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Umma-Kulthum A. Umar
- Emergency Medicine Department, Shaikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Nidal H. Bokhary
- College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saeed F. Alqahtani
- Emergency Medicine Department, Aseer Central Hospital, Abha, Saudi Arabia
| | | | - Hisham F. Alyahya
- Emergency Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Wejdan S. Alzahrani
- Emergency Medicine Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Fawziah Alsalmi
- Emergency Medicine Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | | | | | | | | | - Farid Foroutan
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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