Althunayyan Saqer M, Aledeny Ahmed Abdullah, Malabarey Mohammed A, Alshaqaqiq Ali Ibrahim, Haj-Ali Eyman Okbah, Alhomsi Mhd Walid, Elgazar Hagar Khaled, Alrefaei Tamim S M, AlAsiri Saad Ali
Department of Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia.
Emergency Department, Al-Habib Medical Group, 12214 Riyadh, Saudi Arabia.
Am J Emerg Med. 2025 May;91:118-122. doi: 10.1016/j.ajem.2025.02.042. Epub 2025 Feb 25.
The Lactate-enhanced Quick Sequential Organ Failure Assessment (LqSOFA) has been identified as a tool for predicting sepsis outcomes. We evaluated the predictive power of the LqSOFA for adult patients suspected of having sepsis in the Emergency Department (ED). It was assessed as an indicator for Intensive Care Unit (ICU) admission, the necessity for vasopressors, and mortality within 72 h. This was then compared with the Quick Sequential Organ Failure Assessment (qSOFA).
We conducted a retrospective, cohort observational study of suspected sepsis patients from four branches of Dr. Sulaiman Al-Habib Medical Group (HMG) in Riyadh, Saudi Arabia, from 1 May 2022 to 30 April 2023. We calculated the initial LqSOFA and qSOFA for all patients. The sensitivity, specificity, and area under the receiver operator characteristic (AUROC) curve were evaluated for both LqSOFA and qSOFA scores (with ≥2 criteria) for each targeted outcome.
The study included a total of 1274 patients, the majority of whom were males (754 (59.2 %)), with a mean age of 68.80 ± 17.9 years. LqSOFA demonstrated higher sensitivity for ICU admission, vasopressor requirement, and mortality (48 %, 68 %, and 76 % respectively) in comparison to qSOFA (30 %, 50 %, and 71 % respectively). However, the specificities of the LqSOFA score for ICU admission, vasopressor requirements, and mortality were lower (81 %, 71 %, and 67 % respectively) than those of the qSOFA score (89 %, 83 %, and 80 % respectively). The AUC of LqSOFA was greater than that of qSOFA for each outcome of interest but the difference was only statistically significant for mortality outcome (p-value <0.05).
LqSOFA exhibits strong predictive reliability compared to qSOFA. Prospective multiregional studies need to be conducted to validate LqSOFA's performance.
乳酸增强型快速序贯器官衰竭评估（LqSOFA）已被确定为一种预测脓毒症预后的工具。我们评估了LqSOFA对急诊科（ED）疑似脓毒症成年患者的预测能力。将其作为重症监护病房（ICU）入院、使用血管升压药的必要性以及72小时内死亡率的指标进行评估。然后将其与快速序贯器官衰竭评估（qSOFA）进行比较。
我们对沙特阿拉伯利雅得苏莱曼·哈比卜医学集团（HMG）四个分支机构2022年5月1日至2023年4月30日期间疑似脓毒症患者进行了一项回顾性队列观察研究。我们计算了所有患者的初始LqSOFA和qSOFA。针对每个目标结局，评估了LqSOFA和qSOFA评分（≥2条标准）的敏感性、特异性和受试者操作特征曲线下面积（AUROC）。
该研究共纳入1274例患者，其中大多数为男性（754例（59.2%）），平均年龄为68.80±17.9岁。与qSOFA相比，LqSOFA在ICU入院、血管升压药需求和死亡率方面表现出更高的敏感性（分别为48%、68%和76%）（qSOFA分别为30%、50%和71%）。然而，LqSOFA评分在ICU入院、血管升压药需求和死亡率方面的特异性低于qSOFA评分（分别为81%、71%和67%）（qSOFA评分分别为89%、83%和80%）。对于每个感兴趣的结局，LqSOFA的AUC均大于qSOFA，但差异仅在死亡率结局方面具有统计学意义（p值<0.05）。
与qSOFA相比，LqSOFA具有较强的预测可靠性。需要进行前瞻性多地区研究以验证LqSOFA的性能。
