Prediction of 28-days mortality with sequential organ failure assessment (SOFA), quick SOFA (qSOFA) and systemic inflammatory response syndrome (SIRS) — A retrospective study of medical patients with acute infectious disease

• Published in: International journal of infectious diseases 2019-01, Vol.78, p.1-7
• Main Authors: Gaini, Shahin, Relster, Mette Marie, Pedersen, Court, Johansen, Isik Somuncu
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Communicable Diseases - diagnosis; Communicable Diseases - mortality; Female; Follow-Up Studies; Hospital Mortality; Hospitalization; Humans; Male; Middle Aged; Non-ICU; Organ Dysfunction Scores; Prognosis; qSOFA; Retrospective Studies; Sepsis; Sepsis - diagnosis; Sepsis - mortality; SIRS; SOFA; Systemic Inflammatory Response Syndrome - diagnosis; Systemic Inflammatory Response Syndrome - mortality
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2018.09.020

•SIRS versus Sepsis-3 regarding mortality in medical patients with acute infectious disease.•SOFA score of at least 2 predicts 28-day mortality in medical patients with acute infectious disease.•SOFA score of at least 2 is a better prognostic marker than qSOFA and SIRS in medical patients with acute infectious disease. Evaluating the use of sequential organ failure assessment (SOFA) ≥ 2 compared to quick SOFA (qSOFA) and to systemic inflammatory response syndrome (SIRS) in assessing 28-days mortality in medical patients with acute infection. In total, 323 patients with verified infection were stratified in accordance to Sepsis-3. SOFA, qSOFA and SIRS were calculated using registered variables. Adverse outcome was death within 28-days of admission. In total, 190 (59%) patients had a SOFA score≥2 and the overall in-hospital mortality was 21 (6%). Scores of SOFA and qSOFA were both significantly elevated in non-survivors. SOFA showed good accuracy (Area under the receiver operating characteristic (AUROC)=0.83, 95% CI, 0.76 - 0.90) for 28-days mortality compared with qSOFA (AUROC=0.67, 95% CI, 0.54 - 0.80) and SIRS (AUROC=0.62, 95% Cl 0.49 - 0.74). SOFA was≥2 in all patients who died, while qSOFA and SIRS was≥2 in 8 (38%) and 17 (81%) of the patients who died, respectively. SOFA score≥2 was better than SIRS and qSOFA to predict mortality within 28-days of admission among patients with acute infectious disease.