The association between the quick sequential organ failure assessment score prior to emergency ICU admission and outcomes in adults with suspected infection

Abstract

Background: Sepsis and septic shock are leading causes of mortality world-wide.1 In patients outside the intensive care unit (ICU) a rising qSOFA (quick Sequential Organ Failure Assessment) score correlates with mortality risk.2,3 We sought to investigate if the duration of a qSOFA score ≥ 2 prior to ICU admission further affects outcomes, namely: ICU mortality, in-hospital mortality and length of ICU stay.
Method: A retrospective chart review was performed using the electronic ICU database at a quaternary level hospital in Durban, KwaZulu Natal, examining entries from 1 January 2008 to 31 December 2017. The review included 235 emergency in-hospital adult admissions with suspected infection, of which 144 had a qSOFA score ≥ 2 prior to ICU admission.
Results: There was no significant association between the duration of a qSOFA score ≥ 2 prior to ICU admission and ICU mortality (p = 0.975), in-hospital mortality (p = 0.918) and length of ICU stay until demise (p = 0.848) or discharge (p = 0.624). The qSOFA score was significantly associated with ICU mortality with scores of 0, 1, 2 and 3 resulting in ICU mortality rates of 0%, 22.5%, 53.7% and 84.6% respectively (p < 0.001).
Conclusion: The duration of a qSOFA score ≥ 2 prior to emergency ICU admission was not significantly associated with ICU mortality, in-hospital mortality or length of ICU stay in adults with suspected infection.