The values of SOFA score, qSOFA score and SIRS criteria in predicting the prognosis of adult patients with suspect infection / 中华急诊医学杂志

ABSTRACT

Objective To investigate the clinical values of SOFA score,qSOFA score and SIRS criteria in predicting the prognosis of patients with suspected infection in the emergency department.Methods From January 2015 to April 2017,487 patients aged over 18 years were suspected to be infected and admitted to hospital.SOFA,qSOFA,and SIRS scores were calculated.The mortality and the requirement of ICU treatment were used as prognostic factors for evaluating the validity of each score.The prognostic value of each scoring system was evaluated by the area under the receiver operating characteristic curve (AUROC).Results In 487 patients,the hospital mortality rate was 4.9％,and requirement of ICU treatment rate was 17％.SOFA score predicting hospital mortality and requirement of ICU treatment (AUROC 0.905) were superior to other scores (qSOFA-WBCAUROC 0.778,qSOFAAUROC 0.769,SIRSAUROC 0.64).Compared with the SIRS criteria,patients with a score of ＞1 had higher qSOFA scores (94.47％),but lower sensitivity (44.86％);although SIRS criteria had a higher sensitivity (77.57％),they were less specific (42.63％).When qSOFA was added to the condition of leukocyte abnormalities (＜4× 109/L or ＞ 10× 109/L),the prognosis was improved and the sensitivity and specificity for prognosis were 73.83％ and 71.84％ (qSOFA-WBC score,＞1),respectively.In patients with qSOFA-WBC score,only 6 patients (negative predictive value of 94.2％) died or required ICU treatment.Conclusion The SOFA score is superior to qSOFA and SIRS in predicting the prognosis of patients with suspect infection,and qSOFA-WBC is superior to qSOFA and SIRS in predicting low risk.