학술논문
Predictive Performance of Quick Sequential Organ Failure Assessment Scoring in an Argentinian Hospital
Document Type
article
Author
Source
Journal of Clinical and Diagnostic Research, Vol 12, Iss 10, Pp OC22-OC26 (2018)
Subject
Language
English
ISSN
2249-782X
0973-709X
0973-709X
Abstract
Introduction: The early identification and treatment of sepsis in emergency setting could improve patients’ survival. The Quick-SOFA score is a simple tool that could contribute to this identification. Aim: To evaluate mortality rate in Emergency Department along with predicting sepsis by Quick-SOFA. Materials and Methods: This was an observational, prospective study performed in an emergency department of an Argentine Hospital. The studied patients were ≥18 years of age, with infection or suspicion of infection. For qSOFA, 1 point was assigned for each of following: respiratory rate >21 breaths/ min, systolic arterial blood pressure ≤100 mm Hg, and altered mental status. A qSOFA score of ≥2 was considered positive. To assess the performances of the qSOFA and SIRS, sensitivity and specificity was calculated. Results: A total of 157 patients were included with mean age corresponding to 62.9±19.2 years out of which 76 (48.4%) patients were women. Upon admission, 58/157 (36.9%) patients showed a positive-qSOFA, and 120/157 (76.4%) patients were SIRS positive (≥2 signs). 69/157 (46%) cases developed sepsis; 22/157(14%) patients died during their stay. The discrimination of sepsis using qSOFA was comparable with the SIRS criteria (p=0.399) and the discrimination of in-hospital mortality using qSOFA was better than SIRS criteria (p=0.0488). A qSOFA Area Under the Curve (AUC) for predicting sepsis was 0.765 (95% CI 0.69-0.84) while qSOFA AUC for predicting in-hospital mortality was 0.71, (95% CI 0.59-0.83). Conclusion: The newly introduced qSOFA provided better discrimination than SIRS for predicting in-hospital mortality whereas both scores showed comparable discrimination for predicting sepsis in Emergency Department.