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Multicenter Study
. 2022 Oct 14;17(10):e0275739.
doi: 10.1371/journal.pone.0275739. eCollection 2022.

Predictive validity of the quick Sequential Organ Failure Assessment (qSOFA) score for the mortality in patients with sepsis in Vietnamese intensive care units

Son Ngoc Do  1   2   3 , Chinh Quoc Luong  2   3   4 , My Ha Nguyen  5 , Dung Thi Pham  6 , Nga Thi Nguyen  7 , Dai Quang Huynh  8   9 , Quoc Trong Ai Hoang  10 , Co Xuan Dao  1   2   3 , Thang Dinh Vu  11 , Ha Nhat Bui  12 , Hung Tan Nguyen  13 , Hai Bui Hoang  2   14 , Thuy Thi Phuong Le  15 , Lien Thi Bao Nguyen  16 , Phuoc Thien Duong  17 , Tuan Dang Nguyen  18 , Vuong Hung Le  19 , Giang Thi Tra Pham  20 , Tam Van Bui  7 , Giang Thi Huong Bui  1   2 , Jason Phua  21   22 , Andrew Li  22 , Thao Thi Ngoc Pham  8   9 , Chi Van Nguyen  2   4 , Anh Dat Nguyen  2   4
Affiliations
Multicenter Study

Predictive validity of the quick Sequential Organ Failure Assessment (qSOFA) score for the mortality in patients with sepsis in Vietnamese intensive care units

Son Ngoc Do et al. PLoS One. .

Abstract

Background: The simple scoring systems for predicting the outcome of sepsis in intensive care units (ICUs) are few, especially for limited-resource settings. Therefore, this study aimed to evaluate the accuracy of the quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) score in predicting the mortality of ICU patients with sepsis in Vietnam.

Methods: We did a multicenter cross-sectional study of patients with sepsis (≥18 years old) presenting to 15 adult ICUs throughout Vietnam on the specified days (i.e., 9th January, 3rd April, 3rd July, and 9th October) representing the different seasons of 2019. The primary and secondary outcomes were the hospital and ICU all-cause mortalities, respectively. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the discriminatory ability of the qSOFA score for deaths in the hospital and ICU. The cut-off value of the qSOFA scores was determined by the receiver operating characteristic curve analysis. Upon ICU admission, factors associated with the hospital and ICU mortalities were assessed in univariable and multivariable logistic models.

Results: Of 252 patients, 40.1% died in the hospital, and 33.3% died in the ICU. The qSOFA score had a poor discriminatory ability for both the hospital (AUROC: 0.610 [95% CI: 0.538 to 0.681]; cut-off value: ≥2.5; sensitivity: 34.7%; specificity: 84.1%; PAUROC = 0.003) and ICU (AUROC: 0.619 [95% CI: 0.544 to 0.694]; cutoff value: ≥2.5; sensitivity: 36.9%; specificity: 83.3%; PAUROC = 0.002) mortalities. However, multivariable logistic regression analyses show that the qSOFA score of 3 was independently associated with the increased risk of deaths in both the hospital (adjusted odds ratio, AOR: 3.358; 95% confidence interval, CI: 1.756 to 6.422) and the ICU (AOR: 3.060; 95% CI: 1.651 to 5.671).

Conclusion: In our study, despite having a poor discriminatory value, the qSOFA score seems worthwhile in predicting mortality in ICU patients with sepsis in limited-resource settings.

Clinical trial registration: Clinical trials registry-India: CTRI/2019/01/016898.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The area under the ROC curves of the qSOFA score (AUROC: 0.610 [95% CI: 0.538–0.681]; cut-off value: ≥2.5; sensitivity: 34.7%; specificity: 84.1%; PAUROC = 0.003) for predicting the hospital mortality in ICU patients with sepsis in Vietnamese ICUs.
Abbreviations: AUROC, area under the receiver operating characteristic curve; CI, confidence interval; ICU, intensive care unit; qSOFA, Quick Sequential Organ Failure Assessment; ROC, receiver operating characteristic; SOFA, Quick Sequential Organ Failure Assessment.
See this image and copyright information in PMC

References

    1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al.. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Jama. 2016;315(8):801–10. Epub 2016/02/24. doi: 10.1001/jama.2016.0287 ; PubMed Central PMCID: PMC4968574. - DOI - PMC - PubMed
    1. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al.. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–11. Epub 2020/01/20. doi: 10.1016/S0140-6736(19)32989-7 ; PubMed Central PMCID: PMC6970225. - DOI - PMC - PubMed
    1. Bauer M, Gerlach H, Vogelmann T, Preissing F, Stiefel J, Adam D. Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019- results from a systematic review and meta-analysis. Critical care (London, England). 2020;24(1):239. Epub 2020/05/21. doi: 10.1186/s13054-020-02950-2 ; PubMed Central PMCID: PMC7236499. - DOI - PMC - PubMed
    1. Schultz MJ, Dunser MW, Dondorp AM, Adhikari NK, Iyer S, Kwizera A, et al.. Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future. Intensive care medicine. 2017;43(5):612–24. Epub 2017/03/30. doi: 10.1007/s00134-017-4750-z . - DOI - PubMed
    1. Phua J, Koh Y, Du B, Tang YQ, Divatia JV, Tan CC, et al.. Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. Bmj. 2011;342:d3245. Epub 2011/06/15. doi: 10.1136/bmj.d3245 ; PubMed Central PMCID: PMC3113333 www.icmje.org/coi_disclosure.pdf. - DOI - PMC - PubMed

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