Frequency and significance of qSOFA criteria during adult rapid response team reviews: A prospective cohort study

Resuscitation. 2018 Jan;122:13-18. doi: 10.1016/j.resuscitation.2017.11.036. Epub 2017 Nov 11.

Abstract

Aim: A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes.

Methods: We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia RESULTS: Over a one-month period, there were 282 RRT reviews, 258 of which were included. One hundred out of 258 (38.8%) RRT review patients fulfilled qSOFA criteria. qSOFA positive patients were more likely to be admitted to the intensive care unit (29% vs 18%, P=0.04), to have repeat RRT reviews (27% vs 13%; p=0.007) and die in hospital (31% vs 10%, P<0.001). qSOFA positive patients with suspected infection were more likely to be admitted to the intensive care unit compared to patients with infection alone (37% vs 15%, P=0.002). Eleven of 42 patients (26%) who had infection and qSOFA died whilst in hospital, compared to 8/55 (15%) of patients with infection alone (P=0.2).

Conclusion: Adult patients who are qSOFA positive at the time of their RRT review are at increased risk of in-hospital mortality. The assessment of qSOFA may be a useful triage tool during a RRT review.

Keywords: Infection; RRT call; SOFA; Sepsis; qSOFA.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Hospital Mortality*
  • Hospital Rapid Response Team / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Organ Dysfunction Scores*
  • Outcome and Process Assessment, Health Care
  • Prospective Studies
  • Sepsis / diagnosis*
  • Sepsis / mortality
  • Sepsis / physiopathology
  • Sepsis / therapy
  • Severity of Illness Index