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

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions Pub Date : 2025-01-14 DOI:10.1016/j.ijregi.2025.100567

Pedro Alves da Cruz Gouveia , Nayron Veloso Resende , Sara Menezes Lima Soares , Denise Maria do Nascimento Costa , Vera Magalhães da Silveira

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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.

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应用qSOFA评分和SIRS标准预测巴西累西腓一所大学医院病房疑似感染患者30天死亡率：一项回顾性队列研究

目的：本研究旨在评估快速顺序器官衰竭评估（qSOFA）和全身炎症反应综合征（SIRS）在预测病房环境中疑似感染患者30天死亡率方面的准确性。方法：回顾性观察队列研究的成年患者入院后开始他们的第一个抗生素方案的推定感染。在开始使用抗生素时计算qSOFA和SIRS。采用多变量logistic回归和受试者工作特征（ROC）曲线评估两种评分的预测能力。结果：244例患者中，68例（28%）死亡。75例（31%）患者qSOFA≥2,233例（95%）患者符合至少两项SIRS标准。与30天死亡率显著相关的因素包括年龄超过60岁、癌症、呼吸道感染和qSOFA升高。qSOFA的ROC曲线下面积判别30天死亡率为0.68(95%置信区间0.60 ~ 0.77)，SIRS曲线下面积为0.59(95%置信区间0.51 ~ 0.67)，两曲线间差异无统计学意义（P = 0.056）。结论：qSOFA和SIRS在预测疑似感染的病房患者30天死亡率方面表现不佳，表明在这些情况下需要更好的预后工具。

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