Accuracy of quick sequential organ failure assessment score to predict mortality in hospitalized patients with suspected infection in an HIV/AIDS reference centre in Rio de Janeiro, Brazil
Accuracy of quick sequential organ failure assessment score to predict mortality in hospitalized patients with suspected infection in an HIV/AIDS reference centre in Rio de Janeiro, Brazil
Data
2019
Autores
Moreira, J.
Paixão, A.
Oliveira, J.
Jaló, W.
Manuel, O.
Rodrigues, R.
Oliveira, A.
Tinoco, L.
Lima, J.
Grinsztejn, B.
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Microbiology and Infection
Resumo
Objectives: : To compare the discriminatory capacity of the quick sequential organ failure assessment
(qSOFA) vs. the systemic inflammatory response syndrome (SIRS) score for predicting 30-day mortality
and intensive care unit (ICU) admission in patients with suspicion of infection at an HIV reference centre.
Methods: We performed a prospective cohort study including consecutive adult patients who had sus-
pected infection and who were subsequently admitted to the medical ward. Variables related to qSOFA
and SIRS were measured at admission. The performance (area under the receiver operating curve,
AUROC) of qSOFA (score 2) and SIRS (2 criteria) as a predictor of 30-day mortality and ICU admission
was evaluated.
Results: One hundred seventy-three patients (mean ± standard deviation age, 42.6 ± 12.4 years) were
included in the analysis; 107 (61.8%) were male, and 111 (64.2%) were HIV positive. Respiratory and
gastrointestinal infections occurred in 49 (28.3%) and 23 (13.3%), respectively. The 30-day mortality rate
was 9 (5.2%) of 173. The prognostic performance of qSOFA was similar compared to SIRS, with an AUROC
of 0.68 (95% confidence interval, 0.55e0.81) and 0.69 (95% confidence interval, 0.53e0.86) (p 0.96).
Twenty patients (11%) were admitted to the ICU; qSOFA and SIRS had a similar discriminatory capacity
for ICU admission (AUROC 0.63 (95% confidence interval, 0.51e0.75) and 0.63 (95% confidence interval,
0.50e0.76)), respectively).
Conclusions: We found a poor prognostic accuracy of the qSOFA to predict 30-day mortality in hospi-
talized patients suspected of infection in a setting with a high burden of HIV infection.
Description
Palavras-chave
Intensive care unit, Mortality, qSOFA, Sepsis, SIRS
Citação
Moreira J, Paixão A, Oliveira J, Jaló W, Manuel O, Rodrigues R, Oliveira A, Tinoco L, Lima J, Grinsztejn B, Veloso VG, Japiassú AM, Lamas CC. Accuracy of quick sequential organ failure assessment score to predict mortality in hospitalized patients with suspected infection in an HIV/AIDS reference centre in Rio de Janeiro, Brazil. Clin Microbiol Infect. 2019 Jan;25(1):113.e1-113.e3. doi: 10.1016/j.cmi.2018.08.003.