A study published in Anesthesia & Analgesia compared three sepsis screening tools used to diagnose sepsis during pregnancy.
Researchers studied:
• The Systemic Inflammatory Response Syndrome, or SIRS, criteria.
• The quick Sequential Organ Failure Assessment, or qSOFA (recommended by the Society of Critical Care Medicine and others to replace the SIRS criteria in 2016).
• The Maternal Early Warning, or MEW, criteria.
They retrospectively identified validated maternal sepsis cases during hospitalization for delivery from 1995 to 2012 at seven academic medical centers in the U.S. and Israel. Control patients were matched by date of delivery in a 1 to 4 ratio. They matched 82 sepsis cases to 328 controls.
Researchers found that the most common causes of sepsis were chorioamnionitis (24.4 percent), endometritis (23.2 percent) and pneumonia (11 percent). The SIRS tool had the highest sensitivity but the lowest specificity, while qSOFA had the lowest sensitivity and the highest specificity. The MEW criteria had neither the highest nor lowest sensitivity and specificity.
The study also shows that the mortality rate for those patients who received antibiotics within one hour of diagnosis was 8.3 percent, while the mortality rate was 20 percent for patients who received antibiotics after one hour.
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