Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical in
- PDF / 844,433 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 98 Downloads / 196 Views
(2020) 15:63
RESEARCH ARTICLE
Open Access
Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients Christian Koch1,2*† , Fabian Edinger1,2†, Tobias Fischer1, Florian Brenck1, Andreas Hecker3, Christian Katzer1, Melanie Markmann1, Michael Sander1,2 and Emmanuel Schneck1,2
Abstract Background: It is crucial to rapidly identify sepsis so that adequate treatment may be initiated. Accordingly, the Sequential Organ Failure Assessment (SOFA) and the quick SOFA (qSOFA) scores are used to evaluate intensive care unit (ICU) and non-ICU patients, respectively. As demand for ICU beds rises, the intermediate care unit (IMCU) carries greater importance as a bridge between the ICU and the regular ward. This study aimed to examine the ability of SOFA and qSOFA scores to predict suspected infection and mortality in IMCU patients. Methods: Retrospective data analysis included 13,780 surgical patients treated at the IMCU, ICU, or both between January 01, 2012, and September 30, 2018. Patients were screened for suspected infection (i.e., the commencement of broad-spectrum antibiotics) and then evaluated for the SOFA score, qSOFA score, and the 1992 defined systemic inflammatory response syndrome (SIRS) criteria. Results: Suspected infection was detected in 1306 (18.3%) of IMCU, 1365 (35.5%) of ICU, and 1734 (62.0%) of IMCU/ ICU encounters. Overall, 458 (3.3%) patients died (IMCU 45 [0.6%]; ICU 250 [6.5%]; IMCU/ICU 163 [5.8%]). All investigated scores failed to predict suspected infection independently of the analyzed subgroup. Regarding mortality prediction, the qSOFA score performed sufficiently within the IMCU cohort (AUCROC SIRS 0.72 [0.71–0.72]; SOFA 0.52 [0.51–0.53]; qSOFA 0.82 [0.79–0.84]), while the SOFA score was predictive in patients of the IMCU/ICU cohort (AUCROC SIRS 0.54 [0.53–0.54]; SOFA 0.73 [0.70–0.77]; qSOFA 0.59 [0.58–0.59]). Conclusions: None of the assessed scores was sufficiently able to predict suspected infection in surgical ICU or IMCU patients. While the qSOFA score is appropriate for mortality prediction in IMCU patients, SOFA score prediction quality is increased in critically ill patients. Keywords: Sepsis, Critical care, qSOFA, SOFA, Mortality, Infections
* Correspondence: [email protected] † Christian Koch and Fabian Edinger contributed equally to this work. 1 Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, Rudolf-Buchheim-Street 7, 35392 Giessen, Germany 2 German Center of Infection Research (DZIF), Partner Site Giessen/Marburg/ Langen, Giessen, Germany Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the sour
Data Loading...
