Variation of vital signs with potential to influence the performance of qSOFA scoring in the Ethiopian general population at different altitudes of residency: A multisite cross-sectional study
Open Access
- 4 February 2021
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 16 (2), e0245496
- https://doi.org/10.1371/journal.pone.0245496
Abstract
Introduction The physiological range of different vital signs is dependent on various environmental and individual factors. There is a strong interdependent relationship between vital signs and health conditions. Deviations of the physiological range are commonly used for risk assessment in clinical scores, e.g. respiratory rate (RR) and systolic blood pressure (BPsys) in patients with infections within the quick sequential organ failure assessment (qSOFA) score. A limited number of studies have evaluated the performance of such scores in resource-limited health care settings, showing inconsistent results with mostly poor discriminative power. Divergent standard values of vital parameters in different populations, e.g. could influence the accuracy of various clinical scores. Methods This multisite cross-sectional observational study was performed among Ethiopians residing at various altitudes in the cities of Asella (2400m above sea level (a.s.l.)), Adama (1600m a.s.l.), and Semara (400m a.s.l.). Volunteers from the local general population were asked to complete a brief questionnaire and have vital signs measured. Individuals reporting acute or chronic illness were excluded. Results A positive qSOFA score (i.e. ≥2), indicating severe illness in patients with infection, was common among the studied population (n = 612). The proportion of participants with a positive qSOFA score was significantly higher in Asella (28.1%; 55/196), compared with Adama, (8.3%; 19/230; psys (≤100 mmHg) in 48.5%, 27.8%, and 36.0% in participants from Asella, Adama, and Semara, respectively. Discussion The high positivity rate of qSOFA score in the studied population without signs of acute infection may be explained by variations of the physiological range of different vital signs, possibly related to the altitude of residence. Adaptation of existing scores using local standard values could be helpful for reliable risk assessment.This publication has 31 references indexed in Scilit:
- Predictive performance of quick Sepsis-related Organ Failure Assessment for mortality and ICU admission in patients with infection at the EDThe American Journal of Emergency Medicine, 2016
- The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)JAMA, 2016
- Relationship between altitude and the prevalence of hypertension in Tibet: a systematic reviewHeart, 2015
- A cross-sectional study of differences in 6-min walk distance in healthy adults residing at high altitude versus sea levelExtreme Physiology & Medicine, 2014
- Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort studyScandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2012
- Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific EvidenceScandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2011
- Blood pressure changes in young male subjects exposed to a median altitudeClinical Autonomic Research, 2008
- How Long Shall the Patient Rest Before Clinic Blood Pressure Measurement?American Journal of Hypertension, 2006
- 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertensionJournal of Hypertension, 2003
- Body size, composition, and blood pressure of high‐altitude Quechua from the Peruvian Central Andes (Huancavelica, 3,680 m)American Journal of Human Biology, 2001