Abstract
Objective
The objectives of this study are to investigate the performance of the quick Sepsis-related
Organ Failure Assessment (qSOFA) in predicting mortality and intensive care unit (ICU)
admission in patients with clinically diagnosed infection and to compare its performance
with that of Mortality in Emergency Department Sepsis (MEDS), Acute Physiology and
Chronic Health Evaluation (APACHE) II, and Sepsis-related Organ Failure Assessment
(SOFA).
Methods
From July to December 2015, we retrospectively analyzed 477 patients clinically diagnosed
with infection in the emergency department. We compared the performance of SOFA, MEDS,
APACHE II, and qSOFA in predicting ICU admission and 28-day mortality.
Results
All scores were higher in nonsurvivors and ICU patients than in survivors and non-ICU
patients (P< .001). The area under the receiver operating characteristic curve of qSOFA was lower
than that of MEDS (0.666 vs 0.751; P< .05) and similar to that of SOFA (0.729) and APACHE II (0.732) in predicting 28-day
mortality. The areas under the receiver operating characteristic curve of qSOFA, SOFA,
MEDS, and APACHE II in predicting ICU admission were 0.636, 0.682, 0.661, and 0.640,
respectively. There were no significant differences among the score systems. In patients
with qSOFA scores less than 2 and greater than or equal to 2, 28-day mortality rates
were 17.4% and 42.9% (P< .001), and ICU admission rates were 16.0% and 33.3% (P< .001).
Conclusions
Quick SOFA predicted ICU admission with similar performance to that of SOFA, MEDS,
and APACHE II. Its prognostic ability was similar to that of SOFA and APACHE II but
slightly inferior to that of MEDS.
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References
- The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).JAMA. 2016; 315: 801-810
- Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis And Septic Shock (Sepsis-3).JAMA. 2016; 315: 762-774
- Mortality in Emergency Department Sepsis (MEDS) score: a prospectively derived and validated clinical prediction rule.Crit Care Med. 2003; 31: 670-675
- Mortality in Emergency Department Sepsis (MEDS) score predicts 1-year mortality.Crit Care Med. 2007; 35: 192-198
- APACHE II: a severity of disease classification system.Crit Care Med. 1985; 13: 818-829
- The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine.Intensive Care Med. 1996; 22: 707-710
- Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults.Clin Infect Dis. 2007; 44: S27-S72
- Predictive accuracy and feasibility of risk stratification scores for 28-day mortality of patients with sepsis in an emergency department.Eur J Emerg Med. 2015; 22: 331-337
- Comparison of severity of illness scoring systems in the prediction of hospital mortality in severe sepsis and septic shock.J Emerg Trauma Shock. 2010; 3: 342-347
- Comparison of predisposition, insult/infection, response, and organ dysfunction, Acute Physiology And Chronic Health Evaluation II, and Mortality in Emergency Department Sepsis in patients meeting criteria for early goal-directed therapy and the severe sepsis resuscitation bundle.J Crit Care. 2012; 27: 362-369
- Outcome prediction using clinical scores and biomarkers in patients with presumed severe infection in the emergency department.Med Klin Intensivmed Notfmed. 2012; 107: 558-563
- Severity scores in emergency department patients with presumed infection: a prospective validation study.Crit Care Med. 2016; 44: 539-547
Article Info
Publication History
Published online: June 07, 2016
Accepted:
June 2,
2016
Received in revised form:
May 31,
2016
Received:
May 6,
2016
Footnotes
☆Conflicts of interest and source of funding: None.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
