The prehospital quick SOFA score is associated with in-hospital mortality in noninfected patients: A retrospective, cross-sectional study

Abstract

This study aimed to determine the accuracy of the quick Sequential Organ Failure Assessment (qSOFA) score in predicting mortality among prehospital patients with and without infection. This single-center, retrospective, cross-sectional study was conducted among patients who arrived via the emergency medical services (EMS). We calculated the qSOFA score and Modified Early Warning Score (MEWS) from prehospital records. We identified patients as infected if they received intravenous antibiotics at the emergency department or within the first 24 hours. Receiver operating characteristic analysis was used to evaluate and compare the performance of the qSOFA score, each physiological parameter, and the MEWS in predicting admission and in-hospital mortality in patients with and without infection. Multivariate analysis was used to evaluate the qSOFA score and other risk factors. Out of 1574 prehospital patients, 47.1% were admitted and 3.2% died in the hospital. The performance of the qSOFA score in predicting in-hospital mortality in noninfected patients was 0.70, higher than for each parameter and the MEWS. The areas under the curve for the qSOFA+ model vs. the qSOFA- model was 0.77 vs. 0.68 for noninfected patients (p <0.05) and 0.71 vs. 0.68 for infected patients (p = 0.41). The likelihood ratio test comparing the qSOFA- and qSOFA+ groups demonstrated significant improvement for noninfected patients (p <0.01). Multivariate regression analysis for in-hospital mortality demonstrated that the qSOFA score is an independent prognosticator for in-hospital mortality, especially among noninfected patients (odds ratio, 3.60; p <0.01). In conclusion, the prehospital qSOFA score was associated with in-hospital mortality in noninfected patients and may be a beneficial tool for identifying deteriorating patients in the prehospital setting.

Use of prehospital qSOFA in predicting in-hospital mortality in patients with suspected infection: A retrospective cohort study

“…Currently, several studies have investigated the performance of the prehospital qSOFA score [15–17, 23–26]. Vaittinada Ayar P et al have reported that in-hospital mortality rate was significantly higher in patients with prehospital qSOFA positivity among 332 patients suspected with infection (prehospital qSOFA-positive: 41% [55/133] vs prehospital qSOFA-negative: 18% [36/199], p<0.001) [24].…”

Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score

“…The qSOFA scores ranged from 0 to 3, with a higher score indicating more severe disease [10][11][12]. The mEWS was calculated from vital signs (RR, heart rate, SBP, and body temperature) and mental status (AVPU) [13,14]. The RTS was calculated by applying a special expression including weights using the same variables as the qSOFA.…”

Defining and recognising clinical deterioration in the prehospital setting (PRECLuDE study): a systematic scoping review

“…However, identifying those that are declining into a critically ill state can be challenging 2,3 . In the prehospital environment, early identification of high-risk patients is crucial as it enables early intervention, transportation, and may determine the trajectory of future care 4,5 . There are established ambulance guidelines to diagnose specific conditions such as myocardial infarction, stroke and major trauma.…”