Emmanuel Canet1, David McD Taylor2, Richard Khor3, Vivek Krishnan4, Rinaldo Bellomo5. 1. Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia; Data Analytics Research and Evaluation (DARE) Center, Melbourne University and Austin Hospital, Melbourne, Australia. 2. Emergency Department, Austin Health, Heidelberg, Melbourne, Victoria, Australia; School of Medicine, The University of Melbourne, Parkville, Melbourne, Victoria, Australia. 3. Olivia Newton John Cancer Wellness and Research Centre, Austin Health, Department of Radiation Oncology, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Melbourne University, Victoria, Australia. 4. MKM Health, South Yarra, Melbourne, Victoria, Australia. 5. Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia; Data Analytics Research and Evaluation (DARE) Center, Melbourne University and Austin Hospital, Melbourne, Australia; School of Medicine, The University of Melbourne, Parkville, Melbourne, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: Rinaldo.BELLOMO@austin.org.au.
Abstract
PURPOSE: We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection. PATIENTS AND METHODS: We measured qSOFA in a cohort of 11,205 ED patients with suspected infection. The primary outcome was in-hospital mortality and/or ICU stay ≥3 days. RESULTS: The qSOFA score was positive in 2429 (21.7%) patients. In-hospital mortality, and in-hospital mortality or ICU stay ≥3 days were 12.8% and 17.2% respectively for qSOFA positive patients vs 2.2% and 4.2% for qSOFA negative patients (p < .0001). For the prediction of in-hospital mortality, a positive qSOFA had a positive predictive value (PPV) of 13% (95% CI, 11-14) and a negative predictive value (NPV) of 98% (95% CI, 97-98). For the prediction of in-hospital mortality or ICU stay ≥3 days, the PPV and NPV of a positive qSOFA were 17% (95% CI, 16-19) and 96 (95% CI, 95-96), respectively. CONCLUSION: Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.
PURPOSE: We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection. PATIENTS AND METHODS: We measured qSOFA in a cohort of 11,205 ED patients with suspected infection. The primary outcome was in-hospital mortality and/or ICU stay ≥3 days. RESULTS: The qSOFA score was positive in 2429 (21.7%) patients. In-hospital mortality, and in-hospital mortality or ICU stay ≥3 days were 12.8% and 17.2% respectively for qSOFA positive patients vs 2.2% and 4.2% for qSOFA negative patients (p < .0001). For the prediction of in-hospital mortality, a positive qSOFA had a positive predictive value (PPV) of 13% (95% CI, 11-14) and a negative predictive value (NPV) of 98% (95% CI, 97-98). For the prediction of in-hospital mortality or ICU stay ≥3 days, the PPV and NPV of a positive qSOFA were 17% (95% CI, 16-19) and 96 (95% CI, 95-96), respectively. CONCLUSION: Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.
Authors: Priya A Prasad; Margaret C Fang; Sandra P Martinez; Kathleen D Liu; Kirsten N Kangelaris Journal: J Hosp Med Date: 2021-08 Impact factor: 2.899