Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia.

Müller, Martin; Guignard, Viviane; Schefold, Joerg C.; Leichtle, Alexander Benedikt; Exadaktylos, Aristomenis; Pfortmüller, Carmen (2017). Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia. PLoS ONE, 12(12), e0188913. Public Library of Science 10.1371/journal.pone.0188913

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BACKGROUND Despite on-going advances in medical treatment, the burden of disease of pneumonia remains high. We aimed to determine the association of the qSOFA score with in-hospital mortality, length of hospitalisation, and admission to the intensive care unit (ICU) in patients with pneumonia. Further, in a subgroup analysis, the outcomes were compared for qSOFA in comparison to other risk scores, including the CURB-65 and SIRS scores. METHODS In a retrospective analysis, admission data from the ED of the Bern University Hospital, Switzerland, were screened to identify patients admitted for pneumonia. In addition to clinical characteristics, qSOFA and CURB-65 scores and SIRS criteria were assessed and evaluated with respect to the defined study outcomes. RESULTS 527 patients (median age 66 IQR 50-76) were included in this study. The overall in-hospital mortality was 13.3% (n = 70); 22.0% (n = 116) were transferred to the ICU. The median length of hospitalisation was 7 days (IQR 4-12). In comparison to qSOFA-negative patients, qSOFA-positive patients had increased odds ratios for in-hospital mortality (OR 2.6, 95%:1.4, 4.7, p<0.001) and ICU admission (3.5, 95% CI: 2.0. 5.8, p<0.001) and an increased length of stay (p<0.001). For ICU admission, the specificity of qSOPA-positivity (≥2) was 82.1% and sensitivity 43.0%. For in-hospital mortality, the specificity of qSOPA-positivity (≤2) was 88.9% and sensitivity 24.4%. In the subgroup analysis (n = 366). The area under the receiver operating curve for ICU admission was higher for qSOFA than for the CURB-65 score (p = 0.013). The evaluated scores did not differ significantly in their prognostication of in-hospital mortality (p>0.05). CONCLUSIONS The qSOFA score is associated with in-hospital mortality, ICU admission and length of hospitalisation in ED patients with pneumonia. Subgroup analysis revealed that qSOFA is superior to CURB-65 in respect to prognostication of ICU admission.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Müller, Martin; Schefold, Joerg C.; Leichtle, Alexander Benedikt; Exadaktylos, Aristomenis and Pfortmüller, Carmen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

10 Jan 2018 09:07

Last Modified:

06 Feb 2018 14:59

Publisher DOI:

10.1371/journal.pone.0188913

PubMed ID:

29267291

BORIS DOI:

10.7892/boris.108401

URI:

https://boris.unibe.ch/id/eprint/108401

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