The Quick Sequential Organ Failure Assessment (qSOFA) Score is a Poor Mortality Predictor in Patients with Complicated Intra-abdominal Infections

Abstract

BACKGROUND: Despite the evolution in surgical treatment and antimicrobial therapy in the last years the complicated intra-abdominal infections (cIAIs) are still associated with high morbidity and mortality. Different scoring systems are already available for early prognostic evaluation and yet none has been widely accepted. AIM: Our aim was to evaluate the prognostic accuracy of quick sequential organ failure assessment (qSOFA), one of the most recent scores, in patients with cIAIs. MATERIALS AND METHODS: We studied retrospectively 110 patients with cIAIs admitted to the Department of Surgical Diseases (DSD) at University Hospital “Prof. Dr. Stoyan Kirkovich” Stara Zagora from January 2017 to July 2019. Area under receiver operating characteristics (AUROC) curves of systemic inflammatory response syndrome (SIRS), qSOFA, and Mannheim Peritonitis Index (MPI) were analyzed and a comparison of ROC curves was performed to explore their prognostic performance. RESULTS: Twenty-five (22.7%) patients died during hospitalization. qSOFA score showed poor prognostic accuracy (AUROC = 0.698, 95% CI = 0.566–0.829), worse than MPI score (AUROC = 0.698 vs. 0.844), but better than SIRS (AUROC = 0.698 vs. 0.583). The qSOFA score ≥2 points was observed with lack of sensitivity (32.0%) as outcome predictor. ROC curve analysis showed prognostic inferiority of qSOFA compared to MPI (difference between areas = 0.146, p = 0.0232). CONCLUSION: In patients with cIAIs, quick-SOFA score was observed with poor prognostic performance.