Evaluation of the quick sequential organ failure assessment score plus lactate in critically ill dogs

Abstract

Objectives: To apply the quick sequential organ failure assessment (qSOFA) score to dogs admitted to a veterinary ICU, and evaluate whether the addition of lactate increased the predictive ability of the score.

Materials and methods: A quick sequential organ failure assessment score of 0, 1, 2, or 3 was assigned to each dog based on the following criteria: respiratory rate >22 breaths per minute, altered mentation, systolic blood pressure <100 mmHg. Lactate was added to quick sequential organ failure assessment in an LqSOFA model and assigned to each patient. Disease processes evaluated included sepsis, congestive heart failure, pneumonia and pancreatitis.

Results: Two hundred and sixty-seven client-owned dogs met the inclusion criteria. There was no significant difference in quick sequential organ failure assessment score between survivors and non-survivors. The use of lactate >3, 4, and 5 mmol/L incorporated into the quick sequential organ failure assessment score (L3qSOFA, L4qSOFA, L5qSOFA) distinguished between survival and non-survival (AUC=0.62; AUC=0.64; AUC=0.62, respectively). Lactate alone distinguished between survival and non-survival (AUC=0.63). Lactate concentration was significantly lower in survivors.

Clinical significance: In this study, quick sequential organ failure assessment was not able to predict survival in a general population of critically ill patients. The addition of lactate to the quick sequential organ failure assessment score slightly increased the predictive ability of the score.