Age-adjusted quick Sequential Organ Failure Assessment score for predicting mortality and disease severity in children with infection: a systematic review and meta-analysis

Abstract

We assessed the diagnostic accuracy of the age-adjusted quick Sequential Organ Failure Assessment score (qSOFA) for predicting mortality and disease severity in pediatric patients with suspected or confirmed infection. We conducted a systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science. Eleven studies with a total of 172,569 patients were included in the meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio of the age-adjusted qSOFA for predicting mortality and disease severity were 0.69 (95% confidence interval [CI] 0.53–0.81), 0.71 (95% CI 0.36–0.91), and 6.57 (95% CI 4.46–9.67), respectively. The area under the summary receiver-operating characteristic curve was 0.733. The pooled sensitivity and specificity for predicting mortality were 0.73 (95% CI 0.66–0.79) and 0.63 (95% CI 0.21–0.92), respectively. The pooled sensitivity and specificity for predicting disease severity were 0.73 (95% CI 0.21–0.97) and 0.72 (95% CI 0.11–0.98), respectively. The performance of the age-adjusted qSOFA for predicting mortality and disease severity was better in emergency department patients than in intensive care unit patients. The age-adjusted qSOFA has moderate predictive power and can help in rapidly identifying at-risk children, but its utility may be limited by its insufficient sensitivity.

External validation and updating of clinical severity scores to guide referral of young children with acute respiratory infections in resource-limited primary care settings

“…critical care admission rather than mortality), and if the AVPU scale (vs. GCS) is employed to assess mental status. 44 These all apply to our cohort.…”

Defining the role of host biomarkers in the diagnosis and prognosis of childhood pneumonia – a prospective cohort study

“…The performance of the LqSOFA score is consistent with our broader analysis of the score in children with ARIs, 13 and comparable to that reported in the original derivation and validation study. 12 The LqSOFA score is the largest age-adapted version of the widelyendorsed qSOFA score for adults, 38 and was specifically designed for triaging children presenting from the community. Unlike other paediatric pneumonia risk scores it uses routinely collected data, which facilitated external validation in our resource-limited primary care setting.…”

Prediction of attributable mortality in pediatric patients with cancer admitted to the intensive care unit for suspected infection: A comprehensive evaluation of risk scores

“…The following scores were calculated at 1, 6, 12, and 24 h after ICU admission: Pediatric Risk of Mortality 3 (PRISM‐3), Pediatric Sequential Organ Failure Assessment (pSOFA), Paediatric Logistic Organ Dysfunction 2 (PELOD‐2), and Quick Pediatric Sequential Organ Failure Assessment (qSOFA) 14–20 . The most recent available values for each variable were to calculate the scores at each timepoint.…”

“…Several pediatric sepsis risk scores that predict adverse outcomes within the first 24 h after ICU admission have been developed and validated in the general pediatric population 11,14–20 . These scores can accurately classify the risk of mortality, length of stay (LOS) and other important complications, and are useful for stratifying participant risk in research studies, selecting patients for more intensive interventions, and counseling caregivers 11 .…”