Predictive performance of quick Sepsis-related Organ Failure Assessment for mortality and ICU admission in patients with infection at the ED.
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.
Emergency Department, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Electronic address: wangjunyu1007@163.com.
Jun-Yu
JY
Wang
Emergency Department, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Electronic address: 13581960936@163.com.
Yun-Xia
YX
Chen
Emergency Department, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Electronic address: shubinguo@126.com.
Shu-Bin
SB
Guo
Emergency Department, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Electronic address: meixue96@163.com.
Xue
X
Mei
Emergency Department, First People's Hospital of Tianshui, Gansu 741000, China. Electronic address: yangpeng20160501@163.com.
Peng
P
Yang
D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D002494:Central Nervous System Infections / Q000401:mortality*; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D059413:Intraabdominal Infections / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D063305:Organ Dysfunction Scores; D011014:Pneumonia / Q000401:mortality*; D011379:Prognosis; D011704:Pyelonephritis / Q000401:mortality*; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D018805:Sepsis / Q000401:mortality*; D012720:Severity of Illness Index; D012874:Skin Diseases, Infectious / Q000401:mortality; D018461:Soft Tissue Infections / Q000401:mortality*