Comparison of the quick sequential organ failure assessment and modified early warning score for risk prediction of critical patients in emergency

Abstract

Objective To compare the quick sequential organ failure assessment score (qSOFA) and modified early warning score (MEWS) for predicting critically ill patients in emergency. Methods According to the inclusion criteria, 499 cases were collected. The scores of qSOFA and MEWS were calculated and compared between survival group and death group, non-ICU group and ICU group. The ROC curve was plotted and to predict capacity of the two scoring systems by comparing AUC. Results Of the 499 patients, 462 (92.6%) survived, 37 (7.4%) died, 358 (71.7%) were non-ICU, and 141 (28.3%) were ICU. The scores of qSOFA and MEWS between survival group and death group, non-ICU group and ICU group had significant differences (P < 0.05). The AUC of qSOFA and MEWS was 0.861 and 0.816 by predicting death, and the optimal cutoff values were 1.5 and 4.5.AUC was 0.852 and 0.852 by predicting outcome, and the optimal cutoff values were 1.5 and 4.0. The MEWS and qSOFA score were graded according to MEWS < 4 scores, MEWS ≥ 4 scores and qSOFA < 2 scores, qSOFA ≥ 2 scores respectively. The AUC of the qSOFA grade and MEWS grade were 0.758 and 0.775 by predicting death, 0.716 and 0.767 by predicting outcome. Conclusions qSOFA score can be used to predict critically ill patients in emergency, and the evaluation effect is as same as MEWS score. Key words: Quick sequential organ failure assessment; Modified early warning score; Critical illness; Outcome; Emergency; Comparative study