Hyun Kyung Park1, Won Young Kim2, Myung Chun Kim1, Woong Jung1, Byuk Sung Ko3. 1. Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 2. Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 3. Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea. Electronic address: 2170048@hyumc.com.
Abstract
PURPOSE: It is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) in predicting organ failure in patients with a suspected infection in an emergency department (ED). METHODS: A retrospective observational study was conducted in an ED during a 9-year period. We analyzed the ability of qSOFA compared to SIRS to predict the development of organ failure in patients (defined as an increase in the SOFA score of 2 points or more) using the area under receiver operating characteristic (AUROC) curve. RESULTS: A total of 1009 patients with suspected infection were finally included in the study. The predictive validity of qSOFA for organ failure was higher than that of SIRS (AUROC=0.814 vs. AUROC=0.662, p=0.02). qSOFA was also superior to SIRS in predicting in-hospital mortality (AUROC=0.733 vs. AUROC=0.599, p=0.04). When the qSOFA score was equal to or >1, its sensitivity and specificity to predict organ failure was 75% and 82%, respectively. CONCLUSIONS: qSOFA has a superior ability compared to SIRS in predicting the occurrence of organ failure in patients with a suspected infection. However, given the low sensitivity of qSOFA, further confirmatory tests for organ failure are needed.
PURPOSE: It is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) in predicting organ failure in patients with a suspected infection in an emergency department (ED). METHODS: A retrospective observational study was conducted in an ED during a 9-year period. We analyzed the ability of qSOFA compared to SIRS to predict the development of organ failure in patients (defined as an increase in the SOFA score of 2 points or more) using the area under receiver operating characteristic (AUROC) curve. RESULTS: A total of 1009 patients with suspected infection were finally included in the study. The predictive validity of qSOFA for organ failure was higher than that of SIRS (AUROC=0.814 vs. AUROC=0.662, p=0.02). qSOFA was also superior to SIRS in predicting in-hospital mortality (AUROC=0.733 vs. AUROC=0.599, p=0.04). When the qSOFA score was equal to or >1, its sensitivity and specificity to predict organ failure was 75% and 82%, respectively. CONCLUSIONS: qSOFA has a superior ability compared to SIRS in predicting the occurrence of organ failure in patients with a suspected infection. However, given the low sensitivity of qSOFA, further confirmatory tests for organ failure are needed.
Authors: Vu Quoc Dat; Nguyen Thanh Long; Vu Ngoc Hieu; Nguyen Dinh Hong Phuc; Nguyen Van Kinh; Nguyen Vu Trung; H Rogier van Doorn; Ana Bonell; Behzad Nadjm Journal: BMC Infect Dis Date: 2018-10-26 Impact factor: 3.090