Role of d-dimer and bnp in enhancing the ability of qsofa for early identification of sepsis- a prospective observational study in the emergency department

Introduction: The new definition has abandoned the use of host inflammatory response syndrome criteria (SIRS) in identification of sepsis and eliminated the term severe sepsis. As part of the 2016 SCCM/ESICM evaluation of criteria for identifying septic patients, the task force compared traditional SIRS criteria to other methods, including the Logistic Organ Dysfunction System (LODS) and Sequential Organ Failure Assessment (SOFA) scoring. One limitation of the new definition is the poor sensitivity of the qSOFA scoring system, which likely excludes its use as a screening tool for early sepsis, the stage in which treatment is most effective. We have evaluated the possibility of D dimer and BNP assays in addition to qSOFA score in early identification of sepsis.
Methodology: Using a POC triage meter, D dimers and BNP estimation were performed within one hour of arrival of possible septic patients.
Results: D dimers have significantly improved the performance of qSOFA in identifying true sepsis. (P 0.003)
Conclusion: D dimer estimation can add to early estimation of sepsis in the emergency department.