Role of qSOFA and SOFA Scoring Systems for Predicting In-Hospital Risk of Deterioration in the Emergency Department

Raúl López-Izquierdo, Pablo del Brio-Ibañez, Francisco Martín-Rodríguez, Alicia Mohedano-Moriano, Begoña Polonio-López, Clara Maestre-Miquel, Antonio Viñuela, Carlos Durantez-Fernández, Miguel Á. Castro Villamor and José L. Martín-Conty
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Raúl López-Izquierdo: Emergency Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain
Pablo del Brio-Ibañez: Advanced Life Support Unit, Emergency Medical Services, 40002 Segovia, Spain
Francisco Martín-Rodríguez: Advanced Life Support Unit, Emergency Medical Services, Advanced Clinical Simulation Centre, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
Alicia Mohedano-Moriano: Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
Begoña Polonio-López: Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
Clara Maestre-Miquel: Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
Antonio Viñuela: Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
Carlos Durantez-Fernández: Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
Miguel Á. Castro Villamor: Advanced Clinical Simulation Centre, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
José L. Martín-Conty: Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain

IJERPH, 2020, vol. 17, issue 22, 1-11

Abstract: The objective of this study was to analyze and compare the usefulness of quick sequential organ failure assessment score (qSOFA) and sequential organ failure assessment (SOFA) scores for the detection of early (two-day) mortality in patients transported by emergency medical services (EMSs) to the emergency department (ED) (infectious and non-infectious). We performed a multicentric, prospective and blinded end-point study in adults transported with high priority by ambulance from the scene to the ED with the participation of five hospitals. For each score, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated. We included 870 patients in the final cohort. The median age was 70 years (IQR 54–81 years), and 338 (38.8%) of the participants were women. Two-day mortality was 8.3% (73 cases), and 20.9% of cases were of an infectious pathology. For two-day mortality, the qSOFA presented an AUC of 0.812 (95% CI: 0.75–0.87; p < 0.001) globally with a sensitivity of 84.9 (95% CI: 75.0–91.4) and a specificity of 69.4 (95% CI: 66.1–72.5), and a SOFA of 0.909 (95% CI: 0.86–0.95; p < 0.001) with sensitivity of 87.7 (95% CI: 78.2–93.4) and specificity of 80.7 (95% CI: 77.4–83.3). The qSOFA score can serve as a simple initial assessment to detect high-risk patients, and the SOFA score can be used as an advanced tool to confirm organ dysfunction.

Keywords: SOFA; qSOFA; clinical decision-making; early mortality; clinical deterioration; patient safety; emergency department (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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