A COMPARISON OF SEQUENTIAL ORGAN FAILURE (SOFA) & QUICK SOFA SCORES IN PREDICTING HOSPITAL MORTALITY IN CRITICALLY ILL PATIENTS IN A TERTIARY CARE CENTRE

Abstract

Background: To validate Q-SOFA for predicting In-hospital mortality in patients presenting with sepsis in an ICU setting and comparing it to SOFA (Sequential organ failure assessment) score. To compare the performance of the SOFA score and qSOFA scores for in-hospital mortality prediction among critically ill patients in an ICU setting in a tertiary care center. Aims And Objectives: To compare the performance of the SOFA score and qSOFA scores for in-hospital mortality prediction among critically ill patients in an ICU setting in a tertiary care center This study was done in the D Methodolgy: epartment of Medicine in Kurnool Medical College, Kurnool among patients with age > 18 years with suspected infection who were treated at the ICU of Government General Hospital. In our study Results: 2 scoring systems were used –QSOFA and SOFA –both of which are acceptable scoring systems in sepsis. Each of these scores was analyzed with mortality to determine which test predicted mortality better at discharge and at 28 days post-discharge follow-up. On comparing the SOFA score with mortality it was found that 81.82% of the patients who expired at discharge and 77.78 % of the patients who expired at 28 days postdischarge had a SOFA score more than 11(the median SOFA score). At discharge, the sensitivity along with the specicity of SOFA score was 81.8% and 97.4% respectively and at 28 days follow-up, the sensitivity, and specicity in predicting mortality were 77.78% and 100% respectively. On comparing Q-SOFA score with mortality it was found that 63.64% of the patients who expired at discharge and 77.78% of the patients who expired at 28 days post-discharge had a Q-SOFA score of more than 2. At discharge, the calculated sensitivity, as well as specicity of the Q-SOFA score, was 63.6% and 56.4% respectively and at 28 days post-discharge it was 77.78% and 66.7% respectively. AUROC was also calculated for the above-mentioned scoring systems in denoting its predictive power for mortality in sepsis patients. At both discharge and 28 days post-discharge follow-up, SOFA score was found better in predicting mortality followed by Q-SOFA score. Given that both SOFA and QSOFA have sensitivities close to each other for both In-hospital and 28-day mortality (81.8% vs. 63.6%) and (77.78% vs. 77.78%), the Q-SOFA could be used for rapid assessment before lab investigations are available for early goal-directed therapy, though SOFA is the most accurate score for predicting mortality 1. Sepsis scoring system Q-SOFA showed a sensitivi Conclusion: ty of 63.6 % at discharge and 70% at 28 days follow-up for predicting mortality in patients presenting with sepsis 2. Comparison of SOFA, Q-SOFA it was revealed that SOFA score predicted the mortality of sepsis the best both at discharge and at 28 days follow-up.