Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome

Sepsis is a severe clinical syndrome owing to its high mortality. Quick Sequential Organ Failure Assessment (qSOFA) score has been proposed for the prediction of fatal outcomes in sepsis syndrome in emergency departments. Due to the low predictive performance of the qSOFA score, we propose a modification to the score by adding age. We conducted a multi-center, retrospective cohort study among regional referral centers from various regions of the country. Participants recruited data of patients admitted to emergency departments and obtained a diagnosis of sepsis syndrome. Crude in-hospital mortality was the primary endpoint. A generalized mixed-effects model with random intercepts produced estimates for adverse outcomes. Model-based recursive partitioning demonstrated the effects and thresholds of significant covariates. Scores were internally validated. The H measure compared performances of scores. A total of 580 patients from 22 centers were included for further analysis. Stages of sepsis, age, time to antibiotics, and administration of carbapenem for empirical treatment were entered the final model. Among these, severe sepsis (OR, 4.40; CIs, 2.35–8.21), septic shock (OR, 8.78; CIs, 4.37–17.66), age (OR, 1.03; CIs, 1.02–1.05) and time to antibiotics (OR, 1.05; CIs, 1.01–1.10) were significantly associated with fatal outcomes. A decision tree demonstrated the thresholds for age. We modified the quick Sequential Organ Failure Assessment (mod-qSOFA) score by adding age (> 50 years old = one point) and compared this to the conventional score. H-measures for qSOFA and mod-qSOFA were found to be 0.11 and 0.14, respectively, whereas AUCs of both scores were 0.64. We propose the use of the modified qSOFA score for early risk assessment among sepsis patients for improved triage and management of this fatal syndrome. © 2018 Cag et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Yazar Cag Y.
Karabay O.
Sipahi O.R.
Aksoy F.
Durmus G.
Batirel A.
Ak O.
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/5086
Tek Biçim Adres 10.1371/journal.pone.0204608
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
Scopus İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı PLoS ONE
Dergi Cilt Bilgisi 13
Dergi Sayısı 9
Sayfalar -
Yayın Yılı 2018
Eser Adı
[dc.title]
Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome
Yazar
[dc.contributor.author]
Cag Y.
Yazar
[dc.contributor.author]
Karabay O.
Yazar
[dc.contributor.author]
Sipahi O.R.
Yazar
[dc.contributor.author]
Aksoy F.
Yazar
[dc.contributor.author]
Durmus G.
Yazar
[dc.contributor.author]
Batirel A.
Yazar
[dc.contributor.author]
Ak O.
Yayın Yılı
[dc.date.issued]
2018
Yayıncı
[dc.publisher]
Public Library of Science
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Sepsis is a severe clinical syndrome owing to its high mortality. Quick Sequential Organ Failure Assessment (qSOFA) score has been proposed for the prediction of fatal outcomes in sepsis syndrome in emergency departments. Due to the low predictive performance of the qSOFA score, we propose a modification to the score by adding age. We conducted a multi-center, retrospective cohort study among regional referral centers from various regions of the country. Participants recruited data of patients admitted to emergency departments and obtained a diagnosis of sepsis syndrome. Crude in-hospital mortality was the primary endpoint. A generalized mixed-effects model with random intercepts produced estimates for adverse outcomes. Model-based recursive partitioning demonstrated the effects and thresholds of significant covariates. Scores were internally validated. The H measure compared performances of scores. A total of 580 patients from 22 centers were included for further analysis. Stages of sepsis, age, time to antibiotics, and administration of carbapenem for empirical treatment were entered the final model. Among these, severe sepsis (OR, 4.40; CIs, 2.35–8.21), septic shock (OR, 8.78; CIs, 4.37–17.66), age (OR, 1.03; CIs, 1.02–1.05) and time to antibiotics (OR, 1.05; CIs, 1.01–1.10) were significantly associated with fatal outcomes. A decision tree demonstrated the thresholds for age. We modified the quick Sequential Organ Failure Assessment (mod-qSOFA) score by adding age (> 50 years old = one point) and compared this to the conventional score. H-measures for qSOFA and mod-qSOFA were found to be 0.11 and 0.14, respectively, whereas AUCs of both scores were 0.64. We propose the use of the modified qSOFA score for early risk assessment among sepsis patients for improved triage and management of this fatal syndrome. © 2018 Cag et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Haklar
[dc.rights]
info:eu-repo/semantics/openAccess
ISSN
[dc.identifier.issn]
1932-6203
Dergi Adı
[dc.relation.journal]
PLoS ONE
Dergi Sayısı
[dc.identifier.issue]
9
Dergi Cilt Bilgisi
[dc.identifier.volume]
13
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1371/journal.pone.0204608
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/5086
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
10
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
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10 Şubat 2024 01:49
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