Basham Maleeha Ali, Ghumro Hassan Ali, Syed Muhammad Usman Shah, Saeed Sumayyah, Pervez Syed Annas, Farooque Umar, Kumar Naresh, Imtiaz Zainab, Sajjad Muhsana, Jamal Aisha, Aslam Siddiqui Iqra, Idris Farha
Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2020 Oct 20;12(10):e11071. doi: 10.7759/cureus.11071.
Introduction Sepsis and septic shock (sepsis-induced hypotension not improved by adequate fluid resuscitation) are among the most common reasons for admission to an intensive care unit (ICU) and display high mortality rates. Different scoring systems are used to diagnose and predict the mortality of patients having sepsis. This study aims to validate the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) and Quick Sequential Organ Failure Assessment (qSOFA) in determining the mortality of both septic and non-septic patients. Materials and methods This retrospective cohort study was conducted in May 2018 in the Surgical Intensive Care Unit (SICU) of a tertiary care hospital in Karachi, Pakistan. Past 200 patient records, from January 2018 to April 2018, were examined, and 20 records were discarded due to insufficient data. Sufficient observational data were collected, which was used to assess the validity of the SOFA and qSOFA in determining the mortality rate of sepsis. A comparison of the two modalities was made. Results Out of the 200 patients, 180 were enrolled. Data from their entire ICU stay were used to calculate their initial, highest, and mean SOFA and qSOFA. Mean SOFA score up to nine correlated with a mortality rate of up to <79%, while scores 10 and above predicted a 100% mortality rate. A mean qSOFA score of three predicted a 67% mortality rate. Univariate logistic analysis performed with odds ratio showed that the mean qSOFA score was in comparison more closely able to predict mortality, followed by mean SOFA score (p values < 0.01). Conclusions This study concluded that both SOFA and qSOFA scores are good predictors of mortality. However, qSOFA is more closely accurate in predicting mortality than SOFA. But further analysis with larger sample size for a longer duration as well as the application of these scores in the emergency departments and general wards can prove the precision of this study.
引言 脓毒症和脓毒性休克（经充分液体复苏后仍未改善的脓毒症诱发的低血压）是重症监护病房（ICU）收治患者的最常见原因之一，且死亡率很高。不同的评分系统用于诊断和预测脓毒症患者的死亡率。本研究旨在验证序贯器官衰竭评估（SOFA）和快速序贯器官衰竭评估（qSOFA）在确定脓毒症和非脓毒症患者死亡率方面的预后准确性。
材料与方法 这项回顾性队列研究于2018年5月在巴基斯坦卡拉奇一家三级护理医院的外科重症监护病房（SICU）进行。检查了2018年1月至2018年4月期间的200份患者病历，其中20份因数据不足而被丢弃。收集了足够的观察数据，用于评估SOFA和qSOFA在确定脓毒症死亡率方面的有效性。对这两种方法进行了比较。
结果 200名患者中，180名被纳入研究。利用他们在ICU住院期间的全部数据来计算其初始、最高和平均SOFA及qSOFA评分。平均SOFA评分达到9分时，死亡率高达<79%，而评分10分及以上则预测死亡率为100%。平均qSOFA评分为3分时，预测死亡率为67%。采用比值比进行的单因素逻辑分析表明，平均qSOFA评分相比之下更能准确预测死亡率，其次是平均SOFA评分（p值<0.01）。
结论 本研究得出结论，SOFA和qSOFA评分都是死亡率的良好预测指标。然而，qSOFA在预测死亡率方面比SOFA更准确。但通过更大样本量、更长时间的进一步分析以及这些评分在急诊科和普通病房的应用，可以证明本研究的准确性。
