Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings

被引：3

作者：

Li, Andrew ^{[1
]}

Ling, Lowell ^{[2
]}

Qin, Hanyu ^{[3
]}

Arabi, Yaseen M. ^{[4
]}

Myatra, Sheila Nainan ^{[5
]}

Egi, Moritoki ^{[6
]}

Kim, Je Hyeong ^{[7
]}

Nor, Mohd Basri Mat ^{[8
]}

Son, Do Ngoc ^{[9
]}

Fang, Wen-Feng ^{[10
,11
]}

Wahyuprajitno, Bambang ^{[12
]}

Hashmi, Madiha ^{[13
]}

Faruq, Mohammad Omar ^{[14
]}

Patjanasoontorn, Boonsong ^{[15
]}

Al Bahrani, Maher Jaffer ^{[16
]}

Shrestha, Babu Raja ^{[17
]}

Shrestha, Ujma ^{[17
]}

Nafees, Khalid Mahmood Khan ^{[18
]}

Sann, Kyi Kyi ^{[19
]}

Palo, Jose Emmanuel M. ^{[20
]}

Mendsaikhan, Naranpurev ^{[21
]}

Konkayev, Aidos ^{[22
,23
]}

Detleuxay, Khamsay ^{[24
]}

Chan, Yiong Huak ^{[25
]}

Du, Bin ^{[3
]}

Divatia, Jigeeshu Vasishtha ^{[5
]}

Koh, Younsuck ^{[26
,27
]}

Phua, Jason ^{[1
]}

机构：

[1] Natl Univ Hlth Syst, Natl Univ Hosp, Div Resp & Crit Care Med, Dept Med, Singapore, Singapore

[2] Chinese Univ Hong Kong, Dept Anaesthesia & Intens Care, Hong Kong, Peoples R China

[3] Peking Union Med Coll Hosp, Med Intens Care Unit, State Key Lab Complex Severe & Rare Dis, Beijing, Peoples R China

[4] King Saud Bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Riyadh, Saudi Arabia

[5] Homi Bhabha Natl Inst, Tata Mem Hosp, Dept Anaesthesiol Crit Care & Pain, Mumbai, Maharashtra, India

[6] Kyoto Univ Hosp, Dept Anesthesiol & Intens Care, Kyoto, Japan

[7] Korea Univ, Div Pulm & Crit Care Med, Dept Internal Med,Ansan Hosp, Coll Med, Ansan, South Korea

[8] Int Islamic Univ Malaysia, Med Ctr, Kuantan, Malaysia

[9] VNU Univ Med & Pharm, Hanoi Med Univ, Ctr Crit Care Med, Bach Mai Hosp, Hanoi, Vietnam

[10] Chang Gung Univ, Div Pulm & Crit Care Med, Dept Internal Med, Kaohsiung Chang Gung Mem Hosp,Coll Med, Kaohsiung, Taiwan

[11] Chang Gung Univ Sci & Technol, Dept Resp Care, Chiayi, Taiwan

[12] Univ Airlangga, Dr Soetomo Gen Hosp, Dept Anesthesiol & Reanimat, Intens Care Unit,Fac Med, Surabaya, Indonesia

[13] Aga Khan Univ, Dept Anaesthesiol, Karachi, Pakistan

[14] United Hosp Ltd, Gen Intens Care Unity & Emergency Dept, Dhaka, Bangladesh

[15] Khon Kaen Univ, Div Resp & Crit Care Med, Dept Internal Med, Fac Med, Khon Kaen, Thailand

[16] Royal Hosp, Dept Anesthesia & Crit Care, Muscat, Oman

[17] Kathmandu Med Coll Teaching Hosp, Dept Anesthesia & Intens Care, Kathmandu, Nepal

[18] RIPAS Hosp, Bandar Seri Begawan, Brunei

[19] Univ Med 1, Yangon Gen Hosp, Dept Anaesthesiol & ICU, Yangon, Myanmar

[20] Med City, Acute & Crit Care Inst, Pasig, Philippines

[21] Mongolian Natl Univ Med Sci, Mongolia Japan Hosp, Ulaanbaatar, Mongolia

[22] Astana Med Univ, Anaesthesiol & Intens Care Dept, Astana, Kazakhstan

[23] Natl Sci Ctr Traumatol & Orthopedia, Anaesthesiol & Intens Care Dept, Astana, Kazakhstan

[24] Mahosot Hosp, Adult Intens Care Unit, Viangchan, Laos

[25] Natl Univ Singapore, Yong Loo Lin Sch Med, Biostat Unit, Singapore, Singapore

[26] Univ Ulsan, Asan Med Ctr, Dept Pulm & Crit Care Med, Coll Med, Seoul, South Korea

[27] Natl Univ Hlth Syst, FAST & Chron Programmed, Alexandra Hosp, Singapore, Singapore

来源：

CRITICAL CARE | 2024年 / 28卷 / 01期

关键词：

qSOFA; APACHE; Prediction; Critical care; Infection; Mortality; INTENSIVE-CARE-UNIT; INTERNATIONAL CONSENSUS DEFINITIONS; IN-HOSPITAL MORTALITY; SUSPECTED INFECTION; SEPTIC SHOCK; APACHE-II; PREDICTING MORTALITY; QSOFA SCORE; SOFA SCORE; ACCURACY;

D O I：

10.1186/s13054-024-04804-7

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. Methods This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study. Results Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p<0.001) and UMIC (p<0.001) and not HIC (p=0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p<0.001) and UMIC (p<0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p<0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00-1.18), p=0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h. Conclusions qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions. [Graphical Abstract]

引用

页数：11

共 50 条

[1] Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings
Andrew Li
Lowell Ling
Hanyu Qin
Yaseen M. Arabi
Sheila Nainan Myatra
Moritoki Egi
Je Hyeong Kim
Mohd Basri Mat Nor
Do Ngoc Son
Wen-Feng Fang
Bambang Wahyuprajitno
Madiha Hashmi
Mohammad Omar Faruq
Boonsong Patjanasoontorn
Maher Jaffer Al Bahrani
Babu Raja Shrestha
Ujma Shrestha
Khalid Mahmood Khan Nafees
Kyi Kyi Sann
Jose Emmanuel M. Palo
Naranpurev Mendsaikhan
Aidos Konkayev
Khamsay Detleuxay
Yiong Huak Chan
Bin Du
Jigeeshu Vasishtha Divatia
Younsuck Koh
Jason Phua
[J]. Critical Care, 28
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