Importance of vital signs to the early diagnosis and severity of sepsis

Association between vital signs and sequential organ failure assessment score in patients with sepsis

Tsuneaki Kenzaka, Masanobu Okayama, Shigehiro Kuroki, Miho Fukui, Shinsuke Yahata, Hiroki Hayashi, Akihito Kitao, Daisuke Sugiyama, Eiji Kajii, Masayoshi Hashimoto

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective While much attention is given to the fifth vital sign, the utility of the 4 classic vital signs (blood pressure, respiratory rate, body temperature, and heart rate) has been neglected. The aim of this study was to assess a possible association between vital signs and the Sequential Organ Failure Assessment (SOFA) score in patients with sepsis. Methods We performed a prospective, observational study of 206 patients with sepsis. Blood pressure, respiratory rate, body temperature, and heart rate were measured on arrival at the hospital. The SOFA score was also determined on the day of admission. Results Bivariate correlation analysis showed that all of the vital signs were correlated with the SOFA score. Multiple regression analysis indicated that decreased values of systolic blood pressure (multivariate regression coefficient [Coef] = -0.030, 95% confidence interval [CI] = -0.046 to -0.013) and diastolic blood pressure (Coef = -0.045, 95% CI = -0.070 to -0.019), increased respiratory rate (Coef = 0.176, 95% CI = 0.112 to 0.240), and increased shock index (Coef = 4.232, 95% CI = 2.401 to 6.062) significantly influenced the SOFA score. Conclusion Increased respiratory rate and shock index were significantly correlated with disease severity in patients with sepsis. Evaluation of these signs may therefore improve early identification of severely ill patients at triage, allowing more aggressive and timely interventions to improve the prognosis of these patients.

Original languageEnglish
Pages (from-to)871-876
Number of pages6
JournalInternal Medicine
Volume51
Issue number8
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

Organ Dysfunction Scores
Vital Signs
Early Diagnosis
Sepsis
Respiratory Rate
Blood Pressure
Confidence Intervals
Body Temperature
Shock
Heart Rate
Triage
Observational Studies
Regression Analysis
Prospective Studies

Keywords

  • Respiratory Rate
  • Sepsis
  • Shock Index
  • SOFA
  • Systemic Inflammatory Response Syndrome
  • Vital Signs

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Importance of vital signs to the early diagnosis and severity of sepsis : Association between vital signs and sequential organ failure assessment score in patients with sepsis. / Kenzaka, Tsuneaki; Okayama, Masanobu; Kuroki, Shigehiro; Fukui, Miho; Yahata, Shinsuke; Hayashi, Hiroki; Kitao, Akihito; Sugiyama, Daisuke; Kajii, Eiji; Hashimoto, Masayoshi.

In: Internal Medicine, Vol. 51, No. 8, 2012, p. 871-876.

Research output: Contribution to journalArticle

Kenzaka, Tsuneaki ; Okayama, Masanobu ; Kuroki, Shigehiro ; Fukui, Miho ; Yahata, Shinsuke ; Hayashi, Hiroki ; Kitao, Akihito ; Sugiyama, Daisuke ; Kajii, Eiji ; Hashimoto, Masayoshi. / Importance of vital signs to the early diagnosis and severity of sepsis : Association between vital signs and sequential organ failure assessment score in patients with sepsis. In: Internal Medicine. 2012 ; Vol. 51, No. 8. pp. 871-876.
@article{95087b3f83f8427c9d13f049bca538e6,
title = "Importance of vital signs to the early diagnosis and severity of sepsis: Association between vital signs and sequential organ failure assessment score in patients with sepsis",
abstract = "Objective While much attention is given to the fifth vital sign, the utility of the 4 classic vital signs (blood pressure, respiratory rate, body temperature, and heart rate) has been neglected. The aim of this study was to assess a possible association between vital signs and the Sequential Organ Failure Assessment (SOFA) score in patients with sepsis. Methods We performed a prospective, observational study of 206 patients with sepsis. Blood pressure, respiratory rate, body temperature, and heart rate were measured on arrival at the hospital. The SOFA score was also determined on the day of admission. Results Bivariate correlation analysis showed that all of the vital signs were correlated with the SOFA score. Multiple regression analysis indicated that decreased values of systolic blood pressure (multivariate regression coefficient [Coef] = -0.030, 95{\%} confidence interval [CI] = -0.046 to -0.013) and diastolic blood pressure (Coef = -0.045, 95{\%} CI = -0.070 to -0.019), increased respiratory rate (Coef = 0.176, 95{\%} CI = 0.112 to 0.240), and increased shock index (Coef = 4.232, 95{\%} CI = 2.401 to 6.062) significantly influenced the SOFA score. Conclusion Increased respiratory rate and shock index were significantly correlated with disease severity in patients with sepsis. Evaluation of these signs may therefore improve early identification of severely ill patients at triage, allowing more aggressive and timely interventions to improve the prognosis of these patients.",
keywords = "Respiratory Rate, Sepsis, Shock Index, SOFA, Systemic Inflammatory Response Syndrome, Vital Signs",
author = "Tsuneaki Kenzaka and Masanobu Okayama and Shigehiro Kuroki and Miho Fukui and Shinsuke Yahata and Hiroki Hayashi and Akihito Kitao and Daisuke Sugiyama and Eiji Kajii and Masayoshi Hashimoto",
year = "2012",
doi = "10.2169/internalmedicine.51.6951",
language = "English",
volume = "51",
pages = "871--876",
journal = "Internal Medicine",
issn = "0918-2918",
publisher = "Japanese Society of Internal Medicine",
number = "8",

}

TY - JOUR

T1 - Importance of vital signs to the early diagnosis and severity of sepsis

T2 - Association between vital signs and sequential organ failure assessment score in patients with sepsis

AU - Kenzaka, Tsuneaki

AU - Okayama, Masanobu

AU - Kuroki, Shigehiro

AU - Fukui, Miho

AU - Yahata, Shinsuke

AU - Hayashi, Hiroki

AU - Kitao, Akihito

AU - Sugiyama, Daisuke

AU - Kajii, Eiji

AU - Hashimoto, Masayoshi

PY - 2012

Y1 - 2012

N2 - Objective While much attention is given to the fifth vital sign, the utility of the 4 classic vital signs (blood pressure, respiratory rate, body temperature, and heart rate) has been neglected. The aim of this study was to assess a possible association between vital signs and the Sequential Organ Failure Assessment (SOFA) score in patients with sepsis. Methods We performed a prospective, observational study of 206 patients with sepsis. Blood pressure, respiratory rate, body temperature, and heart rate were measured on arrival at the hospital. The SOFA score was also determined on the day of admission. Results Bivariate correlation analysis showed that all of the vital signs were correlated with the SOFA score. Multiple regression analysis indicated that decreased values of systolic blood pressure (multivariate regression coefficient [Coef] = -0.030, 95% confidence interval [CI] = -0.046 to -0.013) and diastolic blood pressure (Coef = -0.045, 95% CI = -0.070 to -0.019), increased respiratory rate (Coef = 0.176, 95% CI = 0.112 to 0.240), and increased shock index (Coef = 4.232, 95% CI = 2.401 to 6.062) significantly influenced the SOFA score. Conclusion Increased respiratory rate and shock index were significantly correlated with disease severity in patients with sepsis. Evaluation of these signs may therefore improve early identification of severely ill patients at triage, allowing more aggressive and timely interventions to improve the prognosis of these patients.

AB - Objective While much attention is given to the fifth vital sign, the utility of the 4 classic vital signs (blood pressure, respiratory rate, body temperature, and heart rate) has been neglected. The aim of this study was to assess a possible association between vital signs and the Sequential Organ Failure Assessment (SOFA) score in patients with sepsis. Methods We performed a prospective, observational study of 206 patients with sepsis. Blood pressure, respiratory rate, body temperature, and heart rate were measured on arrival at the hospital. The SOFA score was also determined on the day of admission. Results Bivariate correlation analysis showed that all of the vital signs were correlated with the SOFA score. Multiple regression analysis indicated that decreased values of systolic blood pressure (multivariate regression coefficient [Coef] = -0.030, 95% confidence interval [CI] = -0.046 to -0.013) and diastolic blood pressure (Coef = -0.045, 95% CI = -0.070 to -0.019), increased respiratory rate (Coef = 0.176, 95% CI = 0.112 to 0.240), and increased shock index (Coef = 4.232, 95% CI = 2.401 to 6.062) significantly influenced the SOFA score. Conclusion Increased respiratory rate and shock index were significantly correlated with disease severity in patients with sepsis. Evaluation of these signs may therefore improve early identification of severely ill patients at triage, allowing more aggressive and timely interventions to improve the prognosis of these patients.

KW - Respiratory Rate

KW - Sepsis

KW - Shock Index

KW - SOFA

KW - Systemic Inflammatory Response Syndrome

KW - Vital Signs

UR - http://www.scopus.com/inward/record.url?scp=84859839564&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859839564&partnerID=8YFLogxK

U2 - 10.2169/internalmedicine.51.6951

DO - 10.2169/internalmedicine.51.6951

M3 - Article

VL - 51

SP - 871

EP - 876

JO - Internal Medicine

JF - Internal Medicine

SN - 0918-2918

IS - 8

ER -