qSOFA as predictor of mortality and prolonged ICU admission in Emergency Department patients with suspected infection

J Crit Care. 2018 Dec;48:118-123. doi: 10.1016/j.jcrc.2018.08.022. Epub 2018 Aug 21.

Abstract

Purpose: We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection.

Patients and methods: We measured qSOFA in a cohort of 11,205 ED patients with suspected infection. The primary outcome was in-hospital mortality and/or ICU stay ≥3 days.

Results: The qSOFA score was positive in 2429 (21.7%) patients. In-hospital mortality, and in-hospital mortality or ICU stay ≥3 days were 12.8% and 17.2% respectively for qSOFA positive patients vs 2.2% and 4.2% for qSOFA negative patients (p < .0001). For the prediction of in-hospital mortality, a positive qSOFA had a positive predictive value (PPV) of 13% (95% CI, 11-14) and a negative predictive value (NPV) of 98% (95% CI, 97-98). For the prediction of in-hospital mortality or ICU stay ≥3 days, the PPV and NPV of a positive qSOFA were 17% (95% CI, 16-19) and 96 (95% CI, 95-96), respectively.

Conclusion: Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.

Keywords: Emergency department; Infection; Intensive Care Unit; Mortality; Sepsis; qSOFA.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Emergency Service, Hospital
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Length of Stay*
  • Male
  • Middle Aged
  • Organ Dysfunction Scores*
  • Patient Admission*
  • Predictive Value of Tests
  • Prognosis
  • Sensitivity and Specificity
  • Sepsis / mortality*
  • Victoria
  • Young Adult