Evaluating the qSOF


Clinical question: How does the quick Sepsis-Related Organ Failure Assessment (qSOFA) compare with other sepsis scoring tools?

Background: The qSOFA score has been shown to be superior to the Sepsis-Related Organ Failure Assessment (SOFA) with respect to predicting in-hospital mortality outside of the ICU. It has not been compared to other scoring systems or tested among ED patients.

Study design: Single-center, retrospective analysis.

Setting: Hospital ED in China.

Synopsis: A total of 516 adult ED patients with clinically diagnosed infections were followed for 28 days. Calculated scores for qSOFA, SOFA, Mortality in ED Sepsis (MEDS), and Acute Physiology and Chronic Health Evaluation (APACHE) II were compared using ROC curves.

qSOFA was similar to the other scoring systems to predict ICU admission.

The area under the curve for qSOFA to predict 28-day mortality was lower than all other scoring systems but was statistically significant only when compared to MEDS. A qSOFA score of 2 had a positive likelihood ratio of 2.47 to predict mortality (95% CI, 2.3-5.4) and a positive likelihood ratio of 2.08 (95% CI, 1.7-4.1) to predict ICU admission.

Bottom line: qSOFA was similar to other scoring systems to predict 28-day mortality and ICU admission but slightly inferior than MEDS to predict mortality.

Citation: Wang JY, Chen YX, Guo SB, Mei X, Yang P. Predictive performance of quick sepsis-related organ failure assessment for mortality and ICU admission in patients with infection at the ED. Am J Em Med. 2016;34(9):1788-1793