Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection A Systematic Review and Meta-analysis

被引:188
|
作者
Fernando, Shannon M. [1 ,2 ]
Tran, Alexandre
Taljaard, Monica
Cheng, Wei
Rochwerg, Bram
Seely, Andrew J. E.
Perry, Jeffrey J.
机构
[1] Univ Ottawa, Dept Emergency Med, Ottawa Hosp, Civ Campus,Room EM-206,1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada
[2] Univ Ottawa, Dept Med, Ottawa Hosp, Div Crit Care, Civ Campus,Room EM-206,1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada
关键词
INFLAMMATORY RESPONSE SYNDROME; INTERNATIONAL CONSENSUS DEFINITIONS; IN-HOSPITAL MORTALITY; INTENSIVE-CARE-UNIT; EMERGENCY-DEPARTMENT; QSOFA SCORE; PREDICTIVE PERFORMANCE; CLINICAL-CRITERIA; SIRS CRITERIA; SEPSIS;
D O I
10.7326/M17-2820
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The quick Sequential Organ Failure Assessment (qSOFA) has been proposed for prediction of mortality in patients with suspected infection. Purpose: To summarize and compare the prognostic accuracy of qSOFA and the systemic inflammatory response syndrome (SIRS) criteria for prediction of mortality in adult patients with suspected infection. Data Sources: Four databases from inception through November 2017. Study Selection: English-language studies using qSOFA for prediction of mortality (in-hospital, 28-day, or 30-day) in adult patients with suspected infection in the intensive care unit (ICU), emergency department (ED), or hospital wards. Data Extraction: Two investigators independently extracted data and assessed study quality using standard criteria. Data Synthesis: Thirty-eight studies were included (n = 385 333). qSOFA was associated with a pooled sensitivity of 60.8% (95% CI, 51.4% to 69.4%) and a pooled specificity of 72.0% (CI, 63.4% to 79.2%) for mortality. The SIRS criteria were associated with a pooled sensitivity of 88.1% (CI, 82.3% to 92.1%) and a pooled specificity of 25.8% (CI, 17.1% to 36.9%). The pooled sensitivity of qSOFA was higher in the ICU population (87.2% [CI, 75.8% to 93.7%]) than the non-ICU population (51.2% [CI, 43.6% to 58.7%]). The pooled specificity of qSOFA was higher in the non-ICU population (79.6% [CI, 73.3% to 84.7%]) than the ICU population (33.3% [CI, 23.8% to 44.4%]). Limitation: Potential risk of bias in inCIuded studies due to qSOFA interpretation and patient selection. Conclusion: qSOFA had poor sensitivity and moderate specificity for short-term mortality. The SIRS criteria had sensitivity superior to that of qSOFA, supporting their use for screening of patients and as a prompt for treatment initiation.
引用
收藏
页码:266 / +
页数:11
相关论文
共 50 条
  • [1] Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection
    Swartz, Andrew W.
    [J]. ANNALS OF INTERNAL MEDICINE, 2018, 169 (04) : 264 - 264
  • [2] Quick Sequential Organ Failure Assessment as a prognostic factor for infected patients outside the intensive care unit: a systematic review and meta-analysis
    Yan-Cun Liu
    Yuan-Yuan Luo
    Xingyu Zhang
    Song-Tao Shou
    Yu-Lei Gao
    Bin Lu
    Chen Li
    Yan-Fen Chai
    [J]. Internal and Emergency Medicine, 2019, 14 : 603 - 615
  • [3] Quick Sequential Organ Failure Assessment as a prognostic factor for infected patients outside the intensive care unit: a systematic review and meta-analysis
    Liu, Yan-Cun
    Luo, Yuan-Yuan
    Zhang, Xingyu
    Shou, Song-Tao
    Gao, Yu-Lei
    Lu, Bin
    Li, Chen
    Chai, Yan-Fen
    [J]. INTERNAL AND EMERGENCY MEDICINE, 2019, 14 (04) : 603 - 615
  • [4] Prognostic value of prehospital quick sequential organ failure assessment score among patients with suspected infection
    Ayar, Prabakar Vaittinada
    Delay, Mathieu
    Avondo, Aurelie
    Duchateau, Francois-Xavier
    Nadiras, Pierre
    Lapostolle, Frederic
    Chouihed, Tahar
    Freund, Yonathan
    [J]. EUROPEAN JOURNAL OF EMERGENCY MEDICINE, 2019, 26 (05) : 329 - 333
  • [5] Age-adjusted quick Sequential Organ Failure Assessment score for predicting mortality and disease severity in children with infection: a systematic review and meta-analysis
    Eun, Sohyun
    Kim, Haemin
    Kim, Ha Yan
    Lee, Myeongjee
    Bae, Go Eun
    Kim, Heoungjin
    Koo, Chung Mo
    Kim, Moon Kyu
    Yoon, Seo Hee
    [J]. SCIENTIFIC REPORTS, 2021, 11 (01)
  • [6] Age-adjusted quick Sequential Organ Failure Assessment score for predicting mortality and disease severity in children with infection: a systematic review and meta-analysis
    Sohyun Eun
    Haemin Kim
    Ha Yan Kim
    Myeongjee Lee
    Go Eun Bae
    Heoungjin Kim
    Chung Mo Koo
    Moon Kyu Kim
    Seo Hee Yoon
    [J]. Scientific Reports, 11
  • [7] Does lactate enhance the prognostic accuracy of the quick Sequential Organ Failure Assessment for adult patients with sepsis? A systematic review
    Gill, Angus
    Ackermann, Khalia
    Hughes, Clifford
    Lam, Vincent
    Li, Ling
    [J]. BMJ OPEN, 2022, 12 (10):
  • [8] Accuracy of quick Sequential Organ Failure Assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for predicting mortality in hospitalized patients with suspected infection: a meta-analysis of observational studies
    Maitra, S.
    Som, A.
    Bhattacharjee, S.
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2018, 24 (11) : 1123 - 1129
  • [9] Predictive Accuracy of Quick Sequential Organ Failure Assessment for Hospital Mortality Decreases With Increasing Comorbidity Burden Among Patients Admitted for Suspected Infection
    Taylor, Stephanie Parks
    McWilliams, Andrew
    Taylor, Brice T.
    Heffner, Alan C.
    Chou, Shih-Hsiung
    Runyon, Michael
    Cunningham, Kyle
    Evans, Susan L.
    Gibbs, Michael
    Russo, Mark
    Rossman, Whitney
    Murphy, Stephanie E.
    Kowalkowski, Marc A.
    Brown, Ryan
    Burke, Larry
    Furney, Scott
    Hetherington, Timothy
    Howard, Daniel
    Lindblom, Scott
    McCall, Andrea
    McCurdy, Lewis
    Papali, Alfred
    Polk, Christopher
    Spencer, Melanie
    Taylor, Stephanie
    [J]. CRITICAL CARE MEDICINE, 2019, 47 (08) : 1081 - 1088
  • [10] Prognostic accuracy of the quick Sequential Organ Failure Assessment (qSOFA)-lactate criteria for mortality in adults with suspected bacterial infection in the emergency department of a hospital with limited resources
    Sinto, Robert
    Suwarto, Suhendro
    Lie, Khie Chen
    Harimurti, Kuntjoro
    Widodo, Djoko
    Pohan, Herdiman T.
    [J]. EMERGENCY MEDICINE JOURNAL, 2020, 37 (06) : 363 - +