Prognostic Accuracy of Quick Sequential Organ Failure Assessment (qSOFA)-lactate for Mortality of Adult with Infection: a Systematic Review and Meta-Analysis

Abstract

Abstract The high burden of infection mortality worldwide calls for the need for prompt risk assessment of its outcome. This article studied for accuracy of quick Sequential Organ Failure Assessment (qSOFA) combined with lactate measurement in predicting the mortality of adult patients with infection. Literature searching was performed in PubMed/Medline®, CINAHL®, Embase®, CENTRAL®, Proquest®, Scopus®, and hand searching of journals. All studies in searching keywords “infection”, “quick sequential organ failure assessment”, “qsofa”, “lactate” with Medical Subject Headings (MeSH) terms were included. Pooled sensitivity, specificity, and area under the curve (AUC) of qSOFA-lactate accuracy were analysed using the R program. Twenty-six studies comprised of 43,207 adult patients with infection were included in this review. Studies were performed in the emergency department, ward, and intensive care unit, with mortality rates ranging from 3.8% − 53.6%. The pooled sensitivity and specificity of 20 studies were 81.3% (95% CI 72.3%, 87.8%; I2 = 97%, p < 0.01) and 62.3% (95% CI 50.5%, 72.8%; I2 = 100%, p = 0). The AUC of qSOFA-lactate was 0.773 (95% CI 0.74, 0.80). There was no significant difference in accuracy results between septic and non-septic patients. The qSOFA-lactate measurement had good accuracy in predicting mortality in adult infectious patients.