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. 2023 Jan-Dec:29:10760296231218705.
doi: 10.1177/10760296231218705.

Usefulness of the Quick-Sepsis Organ Failure Assessment Score in Cardiovascular Intensive Care Unit to Predict Prognosis in Acute Coronary Syndrome

Amine Bouchlarhem  1   2 , Zakaria Bazid  1   2 , Nabila Ismaili  1   2 , El Ouafi Noha  1   2
Affiliations

Usefulness of the Quick-Sepsis Organ Failure Assessment Score in Cardiovascular Intensive Care Unit to Predict Prognosis in Acute Coronary Syndrome

Amine Bouchlarhem et al. Clin Appl Thromb Hemost. 2023 Jan-Dec.

Abstract

Triage of patients with acute coronary syndrome (ACS) at high risk of in-hospital complications is essential. In this study, we evaluated the quick sepsis organ failure assessment (qSOFA) score as a tool for predicting the prognosis of 964 patients admitted to the cardiovascular intensive care unit (CICU) with ACS over a 4-year period. In total, out of 964 patients included, with a percentage of 4.6% for 30-day mortality. The risk of 30-day mortality was independently associated with qSOFA ≥ 2 at admission (hazard ratio = 2.76, 95% CI 1.32-5.74, p = 0.007). For MACEs, qSOFA ≥ 2 at admission was a predictive factor with (odds ratio = 2.42, 95% CI 1.37-4.36, p = .002). A qSOFA ≥ 2 on admission had an AUC of 0.729 (95% CI [0.694, 0.762]), with a good specificity of 91.6%. For 30-day mortality, an AUC of 0.759 (95%CI [0.726, 0.792]) for cardiogenic shock with specificity of 92.5%. For MACEs, an AUC of 0.702 (95% CI [0.64, 0.700] with a specificity of 95%. Concerning the different scores tested, we found no significant difference between the Zwolle score and the qSOFA score for predicting prognosis, whereas the CADILLAC score was better than qSOFA for predicting 30-day mortality (AUC = 0.829 and De long test = 0.03). However, there was no difference between qSOFA and CADILLAC scores for predicting cardiogenic shock (De Long test at 0.08). This is the first study to evaluate qSOFA as a predictive score for 30-day mortality and MACEs, and the results are very encouraging, particularly for cardiogenic shock.

Keywords: acute coronary syndrome; cardiovascular intensive care unit; major adverse cardiovascular events; mortality; quick sepsis organ failure assessment score.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan–Meier curve for 30-day all-cause mortality. Patients-based qSOFA score on admission (A) and in-hospital MACE (B).
Figure 2.
Figure 2.
Comparison of receiver operating characteristic (ROC) curves for predicting 30-days all-cause mortality (A) and in-hospital MACE (B), respectively, for qSOFA, Zwolle, and CADILLAC score.
Figure 3.
Figure 3.
Comparison of ROC curves for predicting in CICU cardiogenic shock, respectively, for qSOFA, Zwolle, and CADILLAC scores.
See this image and copyright information in PMC

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