Added value of ECOG-Performance Status to qSOFA for predicting 30-day mortality in older patients admitted with suspected infections

Abstract

Abstract Quick Sequential Organ Failure Assessment (qSOFA) is a simple and easy tool for identifying patients with suspected infection, who are at a high risk of poor outcome. However, its predictive performance is still insufficient. The Eastern Cooperative Oncology Group performance status (ECOG-PS) score, a tool to evaluate physical function, has been recently reported to be useful in predicting the prognosis of patients with pneumonia. We aimed to evaluate the added value of ECOG-PS to qSOFA in predicting 30-day mortality in older patients admitted with suspected infections. Of the 1536 enrolled patients, 135 (8.8%) died within 30 days. The area under the curve of the extended model was significantly higher than that of the qSOFA model (0.68 vs. 0.64, p = 0.008). When the risk groups were categorized as follows: low (< 5%), intermediate (5–10%), and high (≥ 10%), 5.0% of those who died and 2.1% of those survived were correctly reclassified by the extended model, with an overall categorized net reclassification improvement of 0.03 (95% confidence interval: -0.06 to 0.30). In conclusion, our results suggest that adding the ECOG-PS score could improve the performance of qSOFA, in predicting the 30-day mortality in older patients admitted with suspected infection.