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Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data
- Source :
- PLoS ONE, PLoS ONE, Vol 16, Iss 7, p e0254343 (2021)
- Publication Year :
- 2021
- Publisher :
- Public Library of Science, 2021.
-
Abstract
- This study aimed to assess the value of quick sequential organ failure assessment (qSOFA) combined with other risk factors in predicting in-hospital mortality in patients presenting to the emergency department with suspected infection. This post-hoc analysis of a prospective multicenter study dataset included 34 emergency departments across Japan (December 2017 to February 2018). We included adult patients (age ≥16 years) who presented to the emergency department with suspected infection. qSOFA was calculated and recorded by senior emergency physicians when they suspected an infection. Different types of sepsis-related risk factors (demographic, functional, and laboratory values) were chosen from prior studies. A logistic regression model was used to assess the predictive value of qSOFA for in-hospital mortality in models based on the following combination of predictors: 1) qSOFA-Only; 2) qSOFA+Age; 3) qSOFA+Clinical Frailty Scale (CFS); 4) qSOFA+Charlson Comorbidity Index (CCI); 5) qSOFA+lactate levels; 6) qSOFA+Age+CCI+CFS+lactate levels. We calculated the area under the receiver operating characteristic curve (AUC) and other key clinical statistics at Youden’s index, where the sum of sensitivity and specificity is maximized. Following prior literature, an AUC >0.9 was deemed to indicate high accuracy; 0.7–0.9, moderate accuracy; 0.5–0.7, low accuracy; and 0.5, a chance result. Of the 951 patients included in the analysis, 151 (15.9%) died during hospitalization. The AUC for predicting in-hospital mortality was 0.627 (95% confidence interval [CI]: 0.580−0.673) for the qSOFA-Only model. Addition of other variables only marginally improved the model’s AUC; the model that included all potentially relevant variables yielded an AUC of only 0.730 (95% CI: 0.687–0.774). Other key statistic values were similar among all models, with sensitivity and specificity of 0.55−0.65 and 0.60−0.75, respectively. In this post-hoc data analysis from a prospective multicenter study based in Japan, combining qSOFA with other sepsis-related risk factors only marginally improved the model’s predictive value.
- Subjects :
- Male
Critical Care and Emergency Medicine
Pulmonology
Epidemiology
Organ Dysfunction Scores
Health Care Providers
030204 cardiovascular system & hematology
Logistic regression
0302 clinical medicine
Mathematical and Statistical Techniques
Medical Conditions
Medicine and Health Sciences
030212 general & internal medicine
Medical Personnel
Hospital Mortality
Prospective Studies
Multidisciplinary
Frailty
Mortality rate
Statistics
Middle Aged
Professions
Infectious Diseases
Child, Preschool
Physical Sciences
Medicine
Research Article
Adult
medicine.medical_specialty
Adolescent
Death Rates
Science
Research and Analysis Methods
Sepsis
03 medical and health sciences
Respiratory Disorders
Signs and Symptoms
Population Metrics
Internal medicine
Physicians
Post-hoc analysis
medicine
Humans
Statistical Methods
Receiver operating characteristic
Population Biology
business.industry
Biology and Life Sciences
Emergency department
medicine.disease
Confidence interval
Health Care
Blood pressure
ROC Curve
Geriatrics
Medical Risk Factors
People and Places
Respiratory Infections
Population Groupings
Clinical Medicine
business
Mathematics
Forecasting
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 16
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....4920993905d872c75cdac4317795c066