Combining quick Sequential Organ Failure Assessment with plasma lactate concentration is comparable to standard Sequential Organ Failure Assessment score in predicting mortality of patients with and without suspected infection

Abstract

PurposeWe sought to determine whether quick Sequential Organ Failure Assessment (qSOFA) score can be used to predict mortality of patients without suspected infection. Materials and methodsUsing prospectively collected data within the first hour of intensive care unit admission, the predictive ability of qSOFA was compared with the Simplified Acute Physiology Score III, Admission Mortality Prediction Model III, Acute Physiology and Chronic Health Evaluation II model, and standard (full-version) SOFA score using area under the receiver operating characteristic (AUROC) curve and Brier score. ResultsOf the 2322 patients included, 279 (12.0%) died after intensive care unit admission. The qSOFA score had a modest ability to predict mortality of all critically ill patients (AUROC, 0.672; 95% confidence interval [CI], 0.638-0.707; Brier score 0.099) including the noninfected patients (AUROC, 0.685; 95% CI, 0.637-0.732; Brier score 0.081). The overall predictive ability and calibration of the qSOFA was comparable to other prognostic scores. Combining qSOFA score with lactate concentrations further enhanced its predictive ability (AUROC, 0.730; 95% CI, 0.694-0.765; Brier score 0.097), comparable to the standard SOFA score. ConclusionsThe qSOFA score had a modest ability to predict mortality of both septic and nonseptic patients; combining qSOFA with plasma lactate had a predictive ability comparable to the standard SOFA score.