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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Japan. smile.kenzaka@jichi.ac.jp
authors.forename: Tsuneaki
authors.initials: T
authors.lastname: Kenzaka
authors.forename: Masanobu
authors.initials: M
authors.lastname: Okayama
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Kuroki
authors.forename: Miho
authors.initials: M
authors.lastname: Fukui
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yahata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Akihito
authors.initials: A
authors.lastname: Kitao
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sugiyama
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajii
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D042241:Early Diagnosis; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D011446:Prospective Studies; D056152:Respiratory Rate / Q000502:physiology; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D012720:Severity of Illness Index; D055986:Vital Signs / Q000502:physiology*