Validity of Sequential Organ Failure Assessment and Quick Sequential Organ Failure Assessment in Assessing Mortality Rate in the Intensive Care Unit With or Without Sepsis

Maleeha Ali Basham; Hassan Ali Ghumro; Muhammad Usman Shah Syed; Sumayyah Saeed; Syed Annas Pervez; Umar Farooque; Naresh Kumar; Zainab Imtiaz; Muhsana Sajjad; Aisha Jamal; Iqra Aslam Siddiqui; Farha Idris

doi:10.7759/cureus.11071

Validity of Sequential Organ Failure Assessment and Quick Sequential Organ Failure Assessment in Assessing Mortality Rate in the Intensive Care Unit With or Without Sepsis

Cureus. 2020 Oct 20;12(10):e11071. doi: 10.7759/cureus.11071.

Affiliations

¹ Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
² Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.
³ Neurology, Dow University of Health Sciences, Karachi, PAK.
⁴ Medicine, Dow University of Health Sciences, Karachi, PAK.
⁵ Internal Medicine, Lahore Medical and Dental College, Lahore, PAK.
⁶ Surgery, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.

Abstract

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.

Keywords: humans; intensive care unit; mortality rate; qsofa; quick sequential organ failure assessment; sepsis; septic shock; sequential organ failure assessment; sofa; validity.