Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.

This study aimed to assess the value of quick sequential organ failure assessment (qSOFA) combined with other risk factors in predicting in-hospital mortality in patients presenting to the emergency department with suspected infection. This post-hoc analysis of a prospective multicenter study datase...

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Autores principales:	Ryo Ueno, Takateru Masubuchi, Atsushi Shiraishi, Satoshi Gando, Toshikazu Abe, Shigeki Kushimoto, Toshihiko Mayumi, Seitaro Fujishima, Akiyoshi Hagiwara, Toru Hifumi, Akira Endo, Takayuki Komatsu, Joji Kotani, Kohji Okamoto, Junichi Sasaki, Yasukazu Shiino, Yutaka Umemura
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f454240b069f4f7da08d4eccfeae619e
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spelling	oai:doaj.org-article:f454240b069f4f7da08d4eccfeae619e2021-12-02T20:06:58ZQuick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.1932-620310.1371/journal.pone.0254343https://doaj.org/article/f454240b069f4f7da08d4eccfeae619e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254343https://doaj.org/toc/1932-6203This study aimed to assess the value of quick sequential organ failure assessment (qSOFA) combined with other risk factors in predicting in-hospital mortality in patients presenting to the emergency department with suspected infection. This post-hoc analysis of a prospective multicenter study dataset included 34 emergency departments across Japan (December 2017 to February 2018). We included adult patients (age ≥16 years) who presented to the emergency department with suspected infection. qSOFA was calculated and recorded by senior emergency physicians when they suspected an infection. Different types of sepsis-related risk factors (demographic, functional, and laboratory values) were chosen from prior studies. A logistic regression model was used to assess the predictive value of qSOFA for in-hospital mortality in models based on the following combination of predictors: 1) qSOFA-Only; 2) qSOFA+Age; 3) qSOFA+Clinical Frailty Scale (CFS); 4) qSOFA+Charlson Comorbidity Index (CCI); 5) qSOFA+lactate levels; 6) qSOFA+Age+CCI+CFS+lactate levels. We calculated the area under the receiver operating characteristic curve (AUC) and other key clinical statistics at Youden's index, where the sum of sensitivity and specificity is maximized. Following prior literature, an AUC >0.9 was deemed to indicate high accuracy; 0.7-0.9, moderate accuracy; 0.5-0.7, low accuracy; and 0.5, a chance result. Of the 951 patients included in the analysis, 151 (15.9%) died during hospitalization. The AUC for predicting in-hospital mortality was 0.627 (95% confidence interval [CI]: 0.580-0.673) for the qSOFA-Only model. Addition of other variables only marginally improved the model's AUC; the model that included all potentially relevant variables yielded an AUC of only 0.730 (95% CI: 0.687-0.774). Other key statistic values were similar among all models, with sensitivity and specificity of 0.55-0.65 and 0.60-0.75, respectively. In this post-hoc data analysis from a prospective multicenter study based in Japan, combining qSOFA with other sepsis-related risk factors only marginally improved the model's predictive value.Ryo UenoTakateru MasubuchiAtsushi ShiraishiSatoshi GandoToshikazu AbeShigeki KushimotoToshihiko MayumiSeitaro FujishimaAkiyoshi HagiwaraToru HifumiAkira EndoTakayuki KomatsuJoji KotaniKohji OkamotoJunichi SasakiYasukazu ShiinoYutaka UmemuraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254343 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ryo Ueno Takateru Masubuchi Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Toru Hifumi Akira Endo Takayuki Komatsu Joji Kotani Kohji Okamoto Junichi Sasaki Yasukazu Shiino Yutaka Umemura Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.
description	This study aimed to assess the value of quick sequential organ failure assessment (qSOFA) combined with other risk factors in predicting in-hospital mortality in patients presenting to the emergency department with suspected infection. This post-hoc analysis of a prospective multicenter study dataset included 34 emergency departments across Japan (December 2017 to February 2018). We included adult patients (age ≥16 years) who presented to the emergency department with suspected infection. qSOFA was calculated and recorded by senior emergency physicians when they suspected an infection. Different types of sepsis-related risk factors (demographic, functional, and laboratory values) were chosen from prior studies. A logistic regression model was used to assess the predictive value of qSOFA for in-hospital mortality in models based on the following combination of predictors: 1) qSOFA-Only; 2) qSOFA+Age; 3) qSOFA+Clinical Frailty Scale (CFS); 4) qSOFA+Charlson Comorbidity Index (CCI); 5) qSOFA+lactate levels; 6) qSOFA+Age+CCI+CFS+lactate levels. We calculated the area under the receiver operating characteristic curve (AUC) and other key clinical statistics at Youden's index, where the sum of sensitivity and specificity is maximized. Following prior literature, an AUC >0.9 was deemed to indicate high accuracy; 0.7-0.9, moderate accuracy; 0.5-0.7, low accuracy; and 0.5, a chance result. Of the 951 patients included in the analysis, 151 (15.9%) died during hospitalization. The AUC for predicting in-hospital mortality was 0.627 (95% confidence interval [CI]: 0.580-0.673) for the qSOFA-Only model. Addition of other variables only marginally improved the model's AUC; the model that included all potentially relevant variables yielded an AUC of only 0.730 (95% CI: 0.687-0.774). Other key statistic values were similar among all models, with sensitivity and specificity of 0.55-0.65 and 0.60-0.75, respectively. In this post-hoc data analysis from a prospective multicenter study based in Japan, combining qSOFA with other sepsis-related risk factors only marginally improved the model's predictive value.
format	article
author	Ryo Ueno Takateru Masubuchi Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Toru Hifumi Akira Endo Takayuki Komatsu Joji Kotani Kohji Okamoto Junichi Sasaki Yasukazu Shiino Yutaka Umemura
author_facet	Ryo Ueno Takateru Masubuchi Atsushi Shiraishi Satoshi Gando Toshikazu Abe Shigeki Kushimoto Toshihiko Mayumi Seitaro Fujishima Akiyoshi Hagiwara Toru Hifumi Akira Endo Takayuki Komatsu Joji Kotani Kohji Okamoto Junichi Sasaki Yasukazu Shiino Yutaka Umemura
author_sort	Ryo Ueno
title	Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.
title_short	Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.
title_full	Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.
title_fullStr	Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.
title_full_unstemmed	Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.
title_sort	quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: post-hoc analysis of prospective multicenter study data.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f454240b069f4f7da08d4eccfeae619e
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Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data.

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