Quick sequential organ failure assessment compared to systemic inflammatory response syndrome for predicting sepsis in emergency department

Abstract

PurposeIt is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) in predicting organ failure in patients with a suspected infection in an emergency department (ED). MethodsA retrospective observational study was conducted in an ED during a 9-year period. We analyzed the ability of qSOFA compared to SIRS to predict the development of organ failure in patients (defined as an increase in the SOFA score of 2 points or more) using the area under receiver operating characteristic (AUROC) curve. ResultsA total of 1009 patients with suspected infection were finally included in the study. The predictive validity of qSOFA for organ failure was higher than that of SIRS (AUROC=0.814 vs. AUROC=0.662, p=0.02). qSOFA was also superior to SIRS in predicting in-hospital mortality (AUROC=0.733 vs. AUROC=0.599, p=0.04). When the qSOFA score was equal to or >1, its sensitivity and specificity to predict organ failure was 75% and 82%, respectively. ConclusionsqSOFA has a superior ability compared to SIRS in predicting the occurrence of organ failure in patients with a suspected infection. However, given the low sensitivity of qSOFA, further confirmatory tests for organ failure are needed.