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J. Clin. Med. 2019, 8(1), 61; https://doi.org/10.3390/jcm8010061

qSOFA is a Poor Predictor of Short-Term Mortality in All Patients: A Systematic Review of 410,000 Patients

1
Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong, China
2
Department of Emergency Medicine, Hospital of South West Denmark, Finsensgade 35, DK-6700 Esbjerg, Denmark
*
Author to whom correspondence should be addressed.
Received: 7 November 2018 / Revised: 28 December 2018 / Accepted: 2 January 2019 / Published: 8 January 2019
(This article belongs to the Section Hematology)
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Abstract

Background: To determine the validity of the Quick Sepsis-Related Organ Failure Assessment (qSOFA) in the prediction of outcome (in-hospital and 1-month mortality, intensive care unit (ICU) admission, and hospital and ICU length of stay) in adult patients with or without suspected infections where qSOFA was calculated and reported; Methods: Cochrane Central of Controlled trials, EMBASE, BIOSIS, OVID MEDLINE, OVID Nursing Database, and the Joanna Briggs Institute EBP Database were the main databases searched. All studies published until 12 April 2018 were considered. All studies except case series, case reports, and conference abstracts were considered. Studies that included patients with neutropenic fever exclusively were excluded. Results: The median AUROC for in-hospital mortality (27 studies with 380,920 patients) was 0.68 (a range of 0.55 to 0.82). A meta-analysis of 377,623 subjects showed a polled AUROC of 0.68 (0.65 to 0.71); however, it also confirmed high heterogeneity among studies (I2 = 98.8%, 95%CI 98.6 to 99.0). The median sensitivity and specificity for in-hospital mortality (24 studies with 118,051 patients) was 0.52 (range 0.16 to 0.98) and 0.81 (0.19 to 0.97), respectively. Median positive and negative predictive values were 0.2 (range 0.07 to 0.38) and 0.94 (0.85 to 0.99), respectively. View Full-Text
Keywords: sepsis; qSOFA; prognosis sepsis; qSOFA; prognosis
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Lo, R.S.L.; Leung, L.Y.; Brabrand, M.; Yeung, C.Y.; Chan, S.Y.; Lam, C.C.Y.; Hung, K.K.C.; Graham, C.A. qSOFA is a Poor Predictor of Short-Term Mortality in All Patients: A Systematic Review of 410,000 Patients. J. Clin. Med. 2019, 8, 61.

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