Application of the qSOFA score and SIRS criteria to predict 30-day mortality in patients with suspected infection in a university hospital ward in Recife, Brazil: A retrospective cohort study

Abstract

Objectives: This study aimed to assess the accuracy of quick sequential organ failure assessment (qSOFA) and systemic inflammatory response syndrome (SIRS) in predicting 30-day mortality in patients with suspected infections in a ward environment.

Methods: Retrospective observational cohort study with adult patients admitted to the medical ward who began their first antibiotic regimen for a presumed infection. The qSOFA and SIRS were calculated at the time antibiotics were initiated. Multivariate logistic regression and receiver operating characteristic (ROC) curves were used to assess the predictive abilities of both scores.

Results: Of the 244 patients, 68 (28%) died. A qSOFA ≥2 was found in 75 (31%) patients, and 233 (95%) patients met at least two SIRS criteria. Significant associations with 30-day mortality included age over 60 years, cancer, respiratory infection, and elevated qSOFA. The discrimination of 30-day mortality using the area under the ROC curve for qSOFA was 0.68 (95% confidence interval 0.60-0.77), whereas the SIRS area under the ROC curve was 0.59 (95% confidence interval 0.51-0.67), with no significant difference between the two curves (P = 0.056).

Conclusions: qSOFA and SIRS performed poorly in predicting 30-day mortality in ward patients with suspected infections, indicating a need for better prognostic tools in these settings.