Abstract
Purpose of Review
Various definitions and scoring systems for sepsis were available but none of them was perfect due to the incomplete knowledge of sepsis syndrome pathobiology. Sepsis is a collection of diseases described mainly by systemic host response to infection. An international consensus first defined sepsis in 1991 and was later updated in 2001. Definitions of sepsis, severe sepsis, and septic shock remained the same for two decades. The systemic inflammatory response syndrome (SIRS) criteria were used widely in hospitals to identify sepsis. The third international consensus definitions for sepsis and septic shock (sepsis-3) recently revisited the definition. Sepsis and septic shock definitions were revised, while severe sepsis was omitted and considered to be redundant.
Recent Findings
The development in understanding sepsis pathobiology led to this new definition by a task force of sepsis clinicians and researchers. The sepsis-related organ failure assessment (SOFA) was developed to recognize sepsis, which replaced the SIRS criteria. Quick SOFA (qSOFA) was developed for patients outside intensive care units (ICUs) as a risk stratification tool to determine patients with suspected infection and poor outcomes in a quicker manner.
Summary
The third international sepsis consensus definitions task force aims to differentiate sepsis from uncomplicated infection and to update definitions of sepsis and septic shock as knowledge of sepsis syndrome pathobiology continues to improve.
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References
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Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369:840–85.
Angus DC, Seymour CW, Coopersmith CM, et al. A framework for the development and interpretation of different sepsis definitions and clinical criteria. Crit Care Med. 2016;44:e113–21.
Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest. 1992;101(6):1644–55. This article discussed the first sepsis criteria from 1992; it is important to understand how sepsis was first defined to appreciate the updates and changes in sepsis-3
Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31(4):1250–6.
Kaukonen KM, Bailey M, Pilcher D, et al. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015;372(17):1629–38.
Vincent J-L, Opal SM, Marshall JC, Tracey KJ. Sepsis definitions: time for change. Lancet. 2013;381(9868):774–5. This article explained the importance for changing sepsis criteria and why it should be revised. It explained that the SIRS criteria can be present in infection and several non-infectious clinical processes, which can cause a misleading diagnosis of sepsis.
Vincent J-L, et al. qSOFA does not replace SIRS in the definition of sepsis. Crit Care. 2016;20(1):210.
Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801–10. This explained the third international consensus definition of sepsis was published in 2016. It reviewed the changes in sepsis-3, which revised the definitions and recommended replacing the SIRS criteria with sepsis-related organ failure assessment (SOFA) score and the use of “quick” qSOFA outside intensive care unit (ICU) in patients with suspected sepsis.
Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):762–74.
Shankar-Hari M, Phillips GS, Levy ML, et al. 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). JAMA. 2016;315(8):775–87.
Brabrand M, Havshoj U, Graham CA. Validation of the qSOFA score for identification of septic patients: a retrospective study. Eur J Intern Med. 2016;36:e35–6.
The Glasgow coma scale (GCS). http://www.glasgowcomascale.org. Accessed 19 Dec. 2016.
Crisma. “What is qSOFA?” qSOFA, 2016, www.qsofa.org/what.php. Accessed 19 Dec. 2016.
Abraham E. New definitions for sepsis and septic shock: continuing evolution but with much still to be done. JAMA. 2016;315(8):757–9.
Ho KM, Lan NS. Combining quick sequential organ failure assessment with plasma lactate concentration is comparable to standard sequential organ failure assessment score in predicting mortality of patients with and without suspected infection. J Crit Care. 2016;38:1–5.
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Dr. Alsulaiman and Dr. Kubiak declare no conflicts of interest.
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Alsulaiman, D., Kubiak, D.W. Criteria for Sepsis: Systemic Inflammatory Response Syndrome (SIRS) and Quick Sepsis-Related Organ Dysfunction Assessment (QSOFA). Curr Emerg Hosp Med Rep 5, 28–32 (2017). https://doi.org/10.1007/s40138-017-0125-6
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DOI: https://doi.org/10.1007/s40138-017-0125-6