Sepsis: usefulness of the qSOFA, qSOFA-65 and MqSOFA scores as predictors of morbidity and mortality
Keywords:
Sepsis, Sepsis scores, qSOFA, qSOFA-65, SOFA, MSOFAAbstract
Objective: To evaluate the usefulness of the qSOFA, qSOFA-65 and MqSOFA scores, as predictors of morbidity and mortality in patients admitted to the Internal Medicine service of the Domingo Luciani Hospital, between May 2022-August 2023. Methods: prospective, observational, analytical, longitudinal cohort study. 190 patients diagnosed with sepsis by qsofa score, were studied. The data were analyzed with SPSS27. Pearson's chi-square was used for the relationship between variables. The prognostic utility of the scores was determined with the receiver operating characteristic (ROC) using the DeLong methodology. Statistical significance was considered if p < 0.05. Results: The average age was 64 ± 16 years, 51.6% male and 7.9 days, the evolution of the disease upon admission. The mixed infectious focus made up 59.3%, with urinary predominating (33.4%). Complications occurred in 84.21% and mortality in 55.78%. Neither score predicted complications. MqSOFA predicted better mortality compared to qSOFA and qSOFA-65 (p = 0.004 and p = 0.001) AUC of 0.740 (95% CI = 0.671 – 0.801), as well as the items Sat/FiO2 < 235 and Glasgow < 13 (AUC 0.673 and 0.616 respectively, p < 0.001) Conclusions: The MqSOFA performed on admission was the best predictor of mortality.
References
Neira-Sanchez, E y Málaga, G. (2016). Sepsis-3 y las nuevas definiciones, ¿es tiempo de abandonar SIRS? Acta médica Perú, 33(3), pp. 217-222. Disponible en: http://bit.ly/3KOeUXD [consultado 04-05-2022].
Singer, M. et al. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA, 315(8), pp. 801–810. DOI: 10.1001/jama.2016.0287
Lee, J y Song, J. (2018). Performance of a quick sofa-65 score as a rapid sepsis screening tool during initial emergency department assessment: A propensity score matching study. J Crit Care, 55, pp. 1–28. DOI: 10.1016/j.jcrc.2019.09.019
Guarino, M. et al. (2021). Predicting in-hospital mortality for sepsis: a comparison between qSOFA and modified qSOFA in a 2-year single-centre retrospective analysis. Eur J Clin Microbiol Infect Dis, 40(4), pp. 825–831. DOI: 10.1007/s10096-020-04086-1
Global Sepsis Alliance. (2021). Sepsis – a global health crisis. Disponible en: https://www.global-sepsis-alliance.org/sepsis [consultado 06-05-2022].
Pierrakos, C y Vincent, J. (2010). Sepsis biomarkers: a review. Crit Care, 14(1), pp. 1-18. DOI: 10.1186/cc8872
Ward, I. et al. (2021). Prognostic accuracy of qSOFA at triage in patients with suspected infection in a Brazilian emergency department. Am J Emerg Med, 50, pp. 41–45. DOI: 10.1016/j.ajem.2021.06.079
Guarino, M. et al. (2022). A 2-year retrospective analysis of the prognostic value of MqSOFA compared to lactate, NEWS and qSOFA in patients with sepsis. Infection, 50, pp. 941–948. DOI: 10.1007/s15010-022-01768-0
Ebrahimian, A., Shahcheragh, S. y Fakhr-Movahedi, A. (2020). Comparing the ability and accuracy of mSOFA, qSOFA, and qSOFA-65 in predicting the status of Nontraumatic Patients Referred to a Hospital Emergency Department: A prospective study. Indian J Crit Care Med, 24(11), pp. 1045–1050. DOI: 10.5005/jp-journals-10071-23656
Niño, ME. et al. (2021). Factores pronósticos de mortalidad por sepsis severa en unidades de cuidado crítico del área metropolitana de Bucaramanga. MedUNAB, 15(1), pp. 7–13. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-998320 [consultado 04-05-2022]
Ministerio del Poder Popular para la Salud. (2021). Anuario de Mortalidad 2016. Disponible en: https://academianacionaldemedicina.org/publicaciones/div/republica-bolivariana-de-venezuela-anuario-de-mortalidad-2016/ [consultado 26-06-2023]
Angus, D., Linde-Zwirble, W., Lidicker, J., Clermont, G., Carcillo, J. y Pinsky, MR. (2001). Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med, 29(7), pp. 1303–1310. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11445675/ [consultado 04-05-2022]
Paoli, CJ., Reynolds, MA., Sinha, M., Gitlin, M. y Crouser, E. (2018). Epidemiology and costs of sepsis in the United States-an analysis based on timing of diagnosis and severity level. Crit Care Med, 46(12), pp. 1889–1897. DOI: 10.1097/CCM.0000000000003342
Grissom, CK. et al. (2010). A modified sequential organ failure assessment score for critical care triage. Disaster Med Public Health Prep, 4(4), pp. 277–284. DOI: 10.1001/dmp.2010.40
Singer, AJ., Ng, J., Thode, HC., Spiegel, R. y Weingart, S. (2017). Quick SOFA scores predict mortality in adult emergency department patients with and without suspected infection. Ann Emerg Med, 69(4), pp. 475–479. DOI: 10.1016/j.annemergmed.2016.10.007
Koch, C. et al. (2020). Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients. World J Emerg Surg, 15(1), pp. 63. DOI: 10.1186/s13017-020-00343-y
Oduncu, AF., Kıyan, GS. y Yalçınlı, S. (2021). Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department. Am J Emerg Med, 48, pp. 54–59. DOI: 10.1016/j.ajem.2021.04.006
Hu, H., Jiang, J-Y. y Yao, N. (2022). Comparison of different versions of the quick sequential organ failure assessment for predicting in-hospital mortality of sepsis patients: A retrospective observational study. World J Emerg Med, 13(2), pp. 114–119. DOI: 10.5847/wjem.j.1920-8642.2022.027
Wang, C., Xu, R., Zeng, Y., Zhao, Y. y Hu, X. (2022). A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis. PLoS One, 17(4), pp. 1-13. DOI: 10.1371/journal.pone.0266755
Julián-Jiménez, A. et al. (2023). Capacidad del qSOFA1-lactato para predecir mortalidad a 30 días en los pacientes atendidos por infección en urgencias. Rev Esp Quimioter, 36(4), pp. 408–415. DOI:10.37201/req/008.2023.
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Multidisciplinary & Health Education Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
