Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia; Data Analytics Research and Evaluation (DARE) Center, Melbourne University and Austin Hospital, Melbourne, Australia.
Emergency Department, Austin Health, Heidelberg, Melbourne, Victoria, Australia; School of Medicine, The University of Melbourne, Parkville, Melbourne, Victoria, Australia.
J Crit Care. 2018 Dec;48:118-123. doi: 10.1016/j.jcrc.2018.08.022. Epub 2018 Aug 21.
We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection.
We measured qSOFA in a cohort of 11,205 ED patients with suspected infection. The primary outcome was in-hospital mortality and/or ICU stay ≥3 days.
The qSOFA score was positive in 2429 (21.7%) patients. In-hospital mortality, and in-hospital mortality or ICU stay ≥3 days were 12.8% and 17.2% respectively for qSOFA positive patients vs 2.2% and 4.2% for qSOFA negative patients (p < .0001). For the prediction of in-hospital mortality, a positive qSOFA had a positive predictive value (PPV) of 13% (95% CI, 11-14) and a negative predictive value (NPV) of 98% (95% CI, 97-98). For the prediction of in-hospital mortality or ICU stay ≥3 days, the PPV and NPV of a positive qSOFA were 17% (95% CI, 16-19) and 96 (95% CI, 95-96), respectively.
Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.
我们评估了快速序贯器官衰竭评估（qSOFA）评分作为急诊科（ED）疑似感染患者住院死亡率或 ICU 住院时间延长的预测指标。
我们对 11205 例疑似感染的 ED 患者进行了 qSOFA 评分。主要结局为住院死亡率和/或 ICU 住院时间≥3 天。
qSOFA 评分阳性的患者有 2429 例（21.7%）。qSOFA 阳性患者的住院死亡率和住院死亡率或 ICU 住院时间≥3 天分别为 12.8%和 17.2%，qSOFA 阴性患者分别为 2.2%和 4.2%（p<0.0001）。对于住院死亡率的预测，qSOFA 阳性的阳性预测值（PPV）为 13%（95%CI，11-14），阴性预测值（NPV）为 98%（95%CI，97-98）。对于住院死亡率或 ICU 住院时间≥3 天的预测，qSOFA 阳性的 PPV 和 NPV 分别为 17%（95%CI，16-19）和 96%（95%CI，95-96）。
在 ED 疑似感染患者中，qSOFA 阳性患者的死亡率和 ICU 住院时间延长风险显著增加。
