Quick Sequential Organ Failure Assessment to identify clinical deterioration in adults with COVID-19: a retrospective cohort.

IF 1.5 4区医学 Q3 NURSING

Revista Latino-Americana De Enfermagem Pub Date : 2025-05-19 eCollection Date: 2025-01-01 DOI:10.1590/1518-8345.7239.4530

Luiz Felipe Sales Mauricio, Cassia Regina Vancini Campanharo, Luiz Humberto Vieri Piacezzi, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista

{"title":"Quick Sequential Organ Failure Assessment to identify clinical deterioration in adults with COVID-19: a retrospective cohort.","authors":"Luiz Felipe Sales Mauricio, Cassia Regina Vancini Campanharo, Luiz Humberto Vieri Piacezzi, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista","doi":"10.1590/1518-8345.7239.4530","DOIUrl":null,"url":null,"abstract":"to evaluate the performance of qSOFA in identifying deterioration in patients with COVID-19.retrospective cohort study conducted between February and August 2020 in the Emergency Department of a private hospital, involving 813 adults. The variables studied included sociodemographic data, clinical characteristics, deterioration, qSOFA on admission and before the event, and outcomes. The performance of qSOFA at both moments was analyzed using the area under the ROC curve.the average age was 69 years. There was a predominance of men (61.5%), white (97.2%), catholic (73.7%), married (89.6%) and employed (66%). Comorbidities were present in 69.7%, and 58.8% were classified as \"urgent\" upon admission. The most frequent deterioration was respiratory failure (16.7%), and the outcome was discharge (68%). Patients with positive qSOFA on admission had a higher percentage of respiratory failure, cardiopulmonary arrest, and \"very urgent\" risk classification, and those with negative qSOFA showed a higher percentage of discharge (p< 0.0001). Upon admission, qSOFA showed 66% sensitivity and 55% specificity, and prior to the event it showed 48% sensitivity and 88% specificity for identifying clinical deterioration. Patients with positive qSOFA on admission were 350 times more likely to experience deterioration.qSOFA showed low sensitivity for identifying deterioration at both moments and high specificity before the event.","PeriodicalId":48692,"journal":{"name":"Revista Latino-Americana De Enfermagem","volume":"33 ","pages":"e4530"},"PeriodicalIF":1.5000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088658/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Latino-Americana De Enfermagem","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1518-8345.7239.4530","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

to evaluate the performance of qSOFA in identifying deterioration in patients with COVID-19.

retrospective cohort study conducted between February and August 2020 in the Emergency Department of a private hospital, involving 813 adults. The variables studied included sociodemographic data, clinical characteristics, deterioration, qSOFA on admission and before the event, and outcomes. The performance of qSOFA at both moments was analyzed using the area under the ROC curve.

the average age was 69 years. There was a predominance of men (61.5%), white (97.2%), catholic (73.7%), married (89.6%) and employed (66%). Comorbidities were present in 69.7%, and 58.8% were classified as "urgent" upon admission. The most frequent deterioration was respiratory failure (16.7%), and the outcome was discharge (68%). Patients with positive qSOFA on admission had a higher percentage of respiratory failure, cardiopulmonary arrest, and "very urgent" risk classification, and those with negative qSOFA showed a higher percentage of discharge (p< 0.0001). Upon admission, qSOFA showed 66% sensitivity and 55% specificity, and prior to the event it showed 48% sensitivity and 88% specificity for identifying clinical deterioration. Patients with positive qSOFA on admission were 350 times more likely to experience deterioration.

qSOFA showed low sensitivity for identifying deterioration at both moments and high specificity before the event.

查看原文本刊更多论文

快速序贯器官衰竭评估识别成人COVID-19临床恶化：一项回顾性队列研究

评估qSOFA在识别COVID-19患者病情恶化方面的表现。2020年2月至8月在一家私立医院急诊科进行的回顾性队列研究，涉及813名成年人。研究的变量包括社会人口学数据、临床特征、病情恶化、入院时和事件发生前的qSOFA和结局。利用ROC曲线下面积分析了qSOFA在两个时刻的性能。平均年龄为69岁。以男性（61.5%）、白人（97.2%）、天主教徒（73.7%）、已婚（89.6%）和在职（66%）居多。69.7%的患者存在合并症，58.8%的患者入院时被列为“紧急”。最常见的恶化是呼吸衰竭（16.7%），结果是出院（68%）。入院时qSOFA阳性的患者发生呼吸衰竭、心肺骤停和“非常紧急”风险分类的比例较高，qSOFA阴性的患者出院的比例较高（p< 0.0001）。入院时，qSOFA的敏感性为66%，特异性为55%；事件发生前，qSOFA识别临床恶化的敏感性为48%，特异性为88%。入院时qSOFA阳性的患者出现恶化的可能性是其350倍。qSOFA在两个时刻识别恶化的敏感性都较低，而在事件发生前具有较高的特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Revista Latino-Americana De Enfermagem NURSING-

自引率

11.10%

发文量

142

期刊介绍： A Revista Latino-Americana de Enfermagem constitui-se no órgão oficial de divulgação científica da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo e do Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em Enfermagem. Foi criada em abril de 1992 sendo sua primeira edição publicada em janeiro de 1993. No período de 1993 a 1997 tinha periodicidade semestral, de 1997 a 2000 trimestral e, a partir de janeiro de 2001, tem periodicidade bimestral. Caracteriza-se como periódico de circulação internacional, abrangendo predominantemente os países da América Latina e Caribe, embora seja também divulgado para assinantes dos Estados Unidos, Portugal e Espanha.