Quick SOFA Better Than SIRS, Severe Sepsis in Identifying Mortality Risk
Quick SOFA had greater prognostic accuracy for in-hospital mortality than did either SIRS or severe sepsis.
HealthDay News — For patients with suspected infection presenting to the emergency department, the quick Sequential Organ Failure Assessment (qSOFA) score is better than systemic inflammatory response syndrome (SIRS) or severe sepsis criteria for identifying patients at high risk of mortality, according to a study published in the Journal of the American Medical Association.
Yonathan Freund, MD, PhD, from Sorbonne Universités in Paris, and colleagues prospectively validated qSOFA as a mortality predictor in an international prospective cohort study. For a 4-week period, consecutive patients who visited the 30 participating emergency departments with suspected infection were included. The analysis included 879 patients.
The researchers found that in-hospital mortality was 8%: 3% and 24%, respectively, for those with qSOFA score lower than 2 vs those with a qSOFA score of 2 or higher. For prediction of in-hospital mortality, the qSOFA performed better than SIRS and severe sepsis, with an area under the receiver operating curve of 0.80 (95% confidence interval [CI], 0.74 to 0.85), compared with 0.65 (95% CI, 0.59 to 0.70) for both SIRS and severe sepsis (P <.001). The hazard ratio for death was 6.2 for qSOFA score (95% CI, 3.8 to 10.3), compared with 3.5 for severe sepsis (95% CI, 2.2 to 5.5).
"These findings provide support for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) criteria in the emergency department setting," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.
Freund Y, Lemachatti N, Krastinova E, et al; French Society of Emergency Medicine Collaborators Group. Prognostic accuracy of sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA. 2017;317:301-308. doi: 10.1001/jama.2016.20329