Study of Clinical Course and Outcome in Patients Admitted with Sepsis using ‘SOFA and qSOFA' Scoring Systems at a Tertiary Care Centre

Jump To References Section

Authors

  • Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharshtra ,IN
  • Professor and Head, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharshtra ,IN

DOI:

https://doi.org/10.18311/mvpjms/2020/v7i2/24585

Keywords:

Sepsis, Sequential Organ Failure Assessment (SOFA), quick Sequential Organ Failure Assessment (qSOFA)

Abstract

Introduction: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The task force in the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) formulated the SOFA score based on six parameters of respiration, coagulation, liver, central nervous system, kidneys and cardiovascular systems representing the major organs of the body. A new score, the qSOFA score (q for quick) was formulated using respiratory rate, systolic blood pressure and altered sensorium. This score was intended to be used at the bedside and without laboratory investigations. Aims and Objectives: To study the clinical course & outcome in patients admitted with sepsis using ‘sofa & qsofa' scoring systems at a tertiary care centre. Materials and Methods: This is a prospective observational study, done between a periods between August 2017 to December 2019 in patients admitted to the Medical Intensive Care Unit of a tertiary care hospital. The total number of patients studied was 180. The SOFA and qSOFA scores were calculated for each patient on admission and after 72 hours. The comorbidities like diabetes and hypertension were also recorded. The clinical features and outcome was correlated with the SOFA and the qSOFA scores. Results: There were 31 deaths (17.22%) out of a total of 180. The highest number of deaths occurred with SOFA scores between 11 to15 which was 16 deaths (51.6%). The highest number of deaths occurred with the qSOFA score 2 which were 24 deaths (77.4). Higher SOFA and qSOFA scores did not always correlate with increased mortality, probably because of other factors like associated comorbidities. Conclusion: This study confirmed the usefulness of SOFA and qSOFA scores to predict mortality and for screening of patients with sepsis. Nevertheless, mortality prediction needs assessment of many other factors such as concomitant comorbidities, infecting organism, site of sepsis, etc, along with SOFA and qSOFA scores. Hence, we should assess the SOFA and qSOFA scores of patients in sepsis and with it also assess the role of clinical history and examination and comorbidities along with other factors, for a complete understanding of the patient.

Downloads

Published

2021-07-31

Issue

Section

Original Research Article

 

References

Singer M, Deutschman C, Seymour C et al. The Third International consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016; 315(8):801-810. https://doi. org/10.1001/jama.2016.0287. PMid: 26903338, PMCid: PMC4968574.

Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. Jul 1996; 22(7):707-710. https://doi.org/10.1007/BF01709751. PMid: 8844239.

Garbero RF, Simíµes AA, Martins GA, Ludmilla Vale da Cruz, Viní­cius Gabriel Monteirovon Zuben. SOFA and qSOFA at admission to the emergency department: Diagnostic sensitivity and relation with prognosis in patients with suspected infection. Turkish Journal of Emergency Medicine. 2019; 19:106-110. https://doi. org/10.1016/j.tjem.2019.05.002. PMid: 31321343, PMCid: PMC6612625.

Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, Pilcher DV. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA. January 17 2017; 317(3).

Eli J. Finkelsztein, Daniel S. Jones, Kevin C. Ma, Maria A. Pabón, Tatiana Delgado, Kiichi Nakahira, John E. Arbo, David A. Berlin, Edward J. Schenck, Augustine M. K. Choi, and Ilias I. Siempos. Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit. Critical Care. 2017; 21:73. https://doi.org/10.1186/s13054-017-1658-5. PMid: 28342442, PMCid: PMC5366240.

Vishal Gupta, Niteen D Karnik , Dhiraj Agrawal . SOFA score and critically Ill elderly patients. Journal of the Association of Physicians of India. July 2017; 65:47.

Hae Jung Na , Eun Suk Jeong , Insu Kim , Won-Young Kim , Kwangha Lee . Clinical application of the quick sepsis-related organ failure assessment score at intensive care unit admission in patients with bacteremia: A single-center experience of Korea. Korean J. Crit. Care. Med. 2017; 32(3):247-255. https://doi.org/10.4266/kjccm.2017.00241. PMid: 31723643, PMCid: PMC6786730.