25. Evaluation of the prognostic valueof qsofa score for predicting mortality in patients with severe acute respiratory infection
Main Article Content
Abstract
Severe acute respiratory infections (SARI) are the leading cause of mortality and morbidity among infectious diseases. Immediate assessment and classification of the patient’s mortality risk are essential. We conducted a retrospective observational study on 794 adults SARI patients at 48 primary and secondary hospitals in Vietnam. Selection criteria included patients ≥ 18 years of age diagnosed with SARI according to the WHO’s definition of SARI. The mortality rate was 4.7% (29/794). The area under the receiver operating characteristic curve (AUROC) for 7-day mortality of qSOFA is 0.6253. The sensitivity and specificity of the qSOFA ≥ 2 were 54.1% and 67%, respectively. This result shows that the mortality predictive value of the qSOFA score in patients with acute respiratory infection is low. More studies about other severe scoring systems are needed to make any clinical recommendations.
Article Details
Keywords
Mortality, qSOFA score, Severe acute respiratory infection
References
1. Fitzner J, Qasmieh S, Mounts AW, et al. Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection. Bull World Health Organ. 2018; 96(2): 122-128. doi:10.2471/BLT.17.194514.
2. World Health Organization. The Global Burden of Disease: 2004 Update. WHO Press, World Health Organization; 2004. Accessed December 12, 2022. https://apps.who.int/iris/handle/10665/43942
3. Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2015; 385(9966): 430-440. doi:10.1016/S0140-6736(14)61698-6.
4. Võ Minh Hiền, Nguyễn Ngọc Huy, Keisuke Y, Lay Myint Y. Đặc điểm dịch tễ học - lâm sàng và các yếu tố nguy cơ của nhiễm khuẩn hô hấp cấp tính nặng ở trẻ em dưới 5 tuổi. Học Thành Phố Hồ Chí Minh. 2019; 23(4): 112-119.
5. Nguyen Y, Nguyen T, Nguyen T, et al. Influenza-related severe acute respiratory infection in the north of Vietnam: healthcare burden and economic impact. Antimicrob Resist Infect Control. 2015; 4(1): P14. doi:10.1186/2047-2994-4-S1-P14.
6. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996; 22(7): 707-710. doi:10.1007/BF01709751.
7. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 801-810. doi:10.1001/jama.2016.0287.
8. Shannon MF, Alexandre T, Monica T, et al. Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection: A Systematic Review and Meta-analysis: Annals of Internal Medicine: Vol 168, No 4. Ann Intern Med. 2018; 168: 266-275. doi:10.7326/M17-2820.
9. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 762-774. doi:10.1001/jama.2016.0288.
10. Finkelsztein EJ, Jones DS, Ma KC, et al. Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit. Crit Care. 2017; 21(1): 73. doi:10.1186/s13054-017-1658-5.
11. Churpek MM, Snyder A, Han X, et al. Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit. Am J Respir Crit Care Med. 2017; 195(7): 906-911. doi:10.1164/rccm.201604-0854OC.
12. Hwang TS, Park HW, Park HY, Park YS. Prognostic Value of Severity Score Change for Septic Shock in the Emergency Room. Diagnostics. 2020; 10(10): 743. doi:10.3390/diagnostics10100743.
13. Hakan A, Halil D, Dogac NO, Mehmet K, Osman AG. Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections. Turk J Med Sci. 2019; 49(3): 860-871. doi:10.3906/sag-1807-231.
14. Goulden R, Hoyle MC, Monis J, et al. qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis. Emerg Med J. 2018; 35(6): 345-349. doi:10.1136/emermed-2017-207120.
15. Graham CA, Leung LY, Long Lo RS, Yeung CY, Yi Chan S, Ching Hung KK. NEWS and qSIRS superior to qSOFA in the prediction of 30-day mortality in emergency department patients in Hong Kong. Ann Med. 2020; 52(7): 403-412. doi:10.1080/07853890.2020.1782462.
16. Jiang J, Yang J, Jin Y, Cao J, Lu Y. Role of qSOFA in predicting mortality of pneumonia: A systematic review and meta-analysis. Medicine (Baltimore). 2018; 97(40): e12634. doi:10.1097/MD.0000000000012634.
17. Müller M, Guignard V, Schefold JC, Leichtle AB, Exadaktylos AK, Pfortmueller CA. Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia. PloS One. 2017; 12(12): e0188913. doi:10.1371/journal.pone.0188913.
18. Ranzani OT, Prina E, Menéndez R, et al. New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study. Am J Respir Crit Care Med. 2017; 196(10): 1287-1297. doi:10.1164/rccm.201611-2262OC.
2. World Health Organization. The Global Burden of Disease: 2004 Update. WHO Press, World Health Organization; 2004. Accessed December 12, 2022. https://apps.who.int/iris/handle/10665/43942
3. Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2015; 385(9966): 430-440. doi:10.1016/S0140-6736(14)61698-6.
4. Võ Minh Hiền, Nguyễn Ngọc Huy, Keisuke Y, Lay Myint Y. Đặc điểm dịch tễ học - lâm sàng và các yếu tố nguy cơ của nhiễm khuẩn hô hấp cấp tính nặng ở trẻ em dưới 5 tuổi. Học Thành Phố Hồ Chí Minh. 2019; 23(4): 112-119.
5. Nguyen Y, Nguyen T, Nguyen T, et al. Influenza-related severe acute respiratory infection in the north of Vietnam: healthcare burden and economic impact. Antimicrob Resist Infect Control. 2015; 4(1): P14. doi:10.1186/2047-2994-4-S1-P14.
6. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996; 22(7): 707-710. doi:10.1007/BF01709751.
7. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 801-810. doi:10.1001/jama.2016.0287.
8. Shannon MF, Alexandre T, Monica T, et al. Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection: A Systematic Review and Meta-analysis: Annals of Internal Medicine: Vol 168, No 4. Ann Intern Med. 2018; 168: 266-275. doi:10.7326/M17-2820.
9. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 762-774. doi:10.1001/jama.2016.0288.
10. Finkelsztein EJ, Jones DS, Ma KC, et al. Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit. Crit Care. 2017; 21(1): 73. doi:10.1186/s13054-017-1658-5.
11. Churpek MM, Snyder A, Han X, et al. Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit. Am J Respir Crit Care Med. 2017; 195(7): 906-911. doi:10.1164/rccm.201604-0854OC.
12. Hwang TS, Park HW, Park HY, Park YS. Prognostic Value of Severity Score Change for Septic Shock in the Emergency Room. Diagnostics. 2020; 10(10): 743. doi:10.3390/diagnostics10100743.
13. Hakan A, Halil D, Dogac NO, Mehmet K, Osman AG. Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections. Turk J Med Sci. 2019; 49(3): 860-871. doi:10.3906/sag-1807-231.
14. Goulden R, Hoyle MC, Monis J, et al. qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis. Emerg Med J. 2018; 35(6): 345-349. doi:10.1136/emermed-2017-207120.
15. Graham CA, Leung LY, Long Lo RS, Yeung CY, Yi Chan S, Ching Hung KK. NEWS and qSIRS superior to qSOFA in the prediction of 30-day mortality in emergency department patients in Hong Kong. Ann Med. 2020; 52(7): 403-412. doi:10.1080/07853890.2020.1782462.
16. Jiang J, Yang J, Jin Y, Cao J, Lu Y. Role of qSOFA in predicting mortality of pneumonia: A systematic review and meta-analysis. Medicine (Baltimore). 2018; 97(40): e12634. doi:10.1097/MD.0000000000012634.
17. Müller M, Guignard V, Schefold JC, Leichtle AB, Exadaktylos AK, Pfortmueller CA. Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia. PloS One. 2017; 12(12): e0188913. doi:10.1371/journal.pone.0188913.
18. Ranzani OT, Prina E, Menéndez R, et al. New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study. Am J Respir Crit Care Med. 2017; 196(10): 1287-1297. doi:10.1164/rccm.201611-2262OC.