Prediction of mortality in sepsis with biomarkers and qSOFA score combination: An observational study in a tertiary care centre of western India

Abstract

Introduction: In any clinical set up, the laboratory biomarkers are very important and can serve in determining the suitable treatment course. In this study, we assumed that considering a combination of biomarkers rather than individual items like lactate, C-reactive protein (CRP) and procalcitonin (PCT) along with qSOFA (quick sequential organ failure assessment) score would be better for predicting 28-day mortality in patients diagnosed with sepsis. Methods: A prospective observational study was conducted in a tertiary care centre in Jaipur, Rajasthan (western India) including 160 participants who were admitted in the intensive care unit (ICU) and diagnosed as sepsis. Detailed history and examination were performed, followed by blood investigations and qSOFA score calculations. Written informed consent was obtained from all participants and institutional ethics committee approval was taken at the beginning of the study. Statistical analysis was done after adequate data collection. Results: Mean CRP [mg/L] was 9±1.41, mean PCT [ng/mL] was 1.6±0.56, mean lactate [mmol/L] was 2.1±1.97 among the study subjects. In this study, specificity (%) of qSOFA+biomarkers (serum lactate, CRP, PCT) was 98.9%, that was more than sensitivity of qSOFA score alone i.e., 40.62%. Although sensitivity (%) of qSOFA was 45.31% that was almost similar to the specificity of qSOFA+biomarkers i.e., 46.8%. Positive predictive value and negative predictive value was also higher in the qSOFA+Biomarker group. Conclusion: The predictive rate of combined method was better than that of qSOFA score alone.