Takeaway
- Among emergency department (ED) patients with suspected sepsis, the quick sequential organ failure assessment (qSOFA) did not outperform or improve on physician judgment in predicting short-term mortality.
Why this matters
- It may not be advisable to risk-stratify these patients using qSOFA scores alone.
- The sensitivity of qSOFA has been modest in some validation studies.
Key results
- Mortality: 8.2% (n=16).
- Mortality prediction (area under the curve) by:
- Physician judgment: 0.80 (95% CI, 0.70-0.89);
- qSOFA: 0.63 (95% CI, 0.53-0.73); and
- Both in combination: 0.79 (95% CI, 0.69-0.89).
Study design
- Secondary analysis of a 2-ED prospective observational study of patients with severe sepsis, hypotension, or elevated lactate, all of infectious etiology per retrospective determination (n=195).
- Authors compared the accuracy of physician judgment vs qSOFA score (retrospectively calculated) in predicting 28-day in-hospital mortality.
- Funding: Medic One Foundation.
Limitations
- A small study at academic centers.
- Physicians may have used qSOFA in decision-making.
- Inclusion criteria specified a sicker population than the one originally used to derive qSOFA.
References
References
