Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia
Despite on-going advances in medical treatment, the burden of disease of pneumonia remains high. We aimed to determine the association of the qSOFA score with in-hospital mortality, length of hospitalisation, and admission to the intensive care unit (ICU) in patients with pneumonia. Further, in a su...
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| description | Despite on-going advances in medical treatment, the burden of disease of pneumonia remains high. We aimed to determine the association of the qSOFA score with in-hospital mortality, length of hospitalisation, and admission to the intensive care unit (ICU) in patients with pneumonia. Further, in a subgroup analysis, the outcomes were compared for qSOFA in comparison to other risk scores, including the CURB-65 and SIRS scores.
In a retrospective analysis, admission data from the ED of the Bern University Hospital, Switzerland, were screened to identify patients admitted for pneumonia. In addition to clinical characteristics, qSOFA and CURB-65 scores and SIRS criteria were assessed and evaluated with respect to the defined study outcomes.
527 patients (median age 66 IQR 50-76) were included in this study. The overall in-hospital mortality was 13.3% (n = 70); 22.0% (n = 116) were transferred to the ICU. The median length of hospitalisation was 7 days (IQR 4-12). In comparison to qSOFA-negative patients, qSOFA-positive patients had increased odds ratios for in-hospital mortality (OR 2.6, 95%:1.4, 4.7, p |
| doi_str_mv | 10.1371/journal.pone.0188913 |
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In a retrospective analysis, admission data from the ED of the Bern University Hospital, Switzerland, were screened to identify patients admitted for pneumonia. In addition to clinical characteristics, qSOFA and CURB-65 scores and SIRS criteria were assessed and evaluated with respect to the defined study outcomes.
527 patients (median age 66 IQR 50-76) were included in this study. The overall in-hospital mortality was 13.3% (n = 70); 22.0% (n = 116) were transferred to the ICU. The median length of hospitalisation was 7 days (IQR 4-12). In comparison to qSOFA-negative patients, qSOFA-positive patients had increased odds ratios for in-hospital mortality (OR 2.6, 95%:1.4, 4.7, p<0.001) and ICU admission (3.5, 95% CI: 2.0. 5.8, p<0.001) and an increased length of stay (p<0.001). For ICU admission, the specificity of qSOPA-positivity (≥2) was 82.1% and sensitivity 43.0%. For in-hospital mortality, the specificity of qSOPA-positivity (≤2) was 88.9% and sensitivity 24.4%. In the subgroup analysis (n = 366). The area under the receiver operating curve for ICU admission was higher for qSOFA than for the CURB-65 score (p = 0.013). The evaluated scores did not differ significantly in their prognostication of in-hospital mortality (p>0.05).
The qSOFA score is associated with in-hospital mortality, ICU admission and length of hospitalisation in ED patients with pneumonia. Subgroup analysis revealed that qSOFA is superior to CURB-65 in respect to prognostication of ICU admission.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0188913</identifier><identifier>PMID: 29267291</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adults ; Analysis ; Biology and Life Sciences ; Blood pressure ; Chronic obstructive pulmonary disease ; Comparative analysis ; Data processing ; Development and progression ; Diagnosis ; Emergency medical care ; Family medical history ; Hospitals ; Infections ; Intensive care ; Laboratories ; Medical diagnosis ; Medical research ; Medical treatment ; Medicine ; Medicine and Health Sciences ; Mortality ; Patient admissions ; Patient outcomes ; Patients ; Pneumonia ; Prognosis ; Risk factors ; Sensitivity ; Sensitivity analysis ; Sepsis ; Switzerland</subject><ispartof>PloS one, 2017-12, Vol.12 (12), p.e0188913-e0188913</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Müller et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Müller et al 2017 Müller et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-c554baac16694c991a53cda98ba9a3215b447480e692485271116f21ceae23</citedby><cites>FETCH-LOGICAL-c593t-c554baac16694c991a53cda98ba9a3215b447480e692485271116f21ceae23</cites><orcidid>0000-0003-0326-2770</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739400/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739400/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29267291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Müller, Martin</creatorcontrib><creatorcontrib>Guignard, Viviane</creatorcontrib><creatorcontrib>Schefold, Joerg C</creatorcontrib><creatorcontrib>Leichtle, Alexander B</creatorcontrib><creatorcontrib>Exadaktylos, Aristomenis K</creatorcontrib><creatorcontrib>Pfortmueller, Carmen A</creatorcontrib><title>Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Despite on-going advances in medical treatment, the burden of disease of pneumonia remains high. We aimed to determine the association of the qSOFA score with in-hospital mortality, length of hospitalisation, and admission to the intensive care unit (ICU) in patients with pneumonia. Further, in a subgroup analysis, the outcomes were compared for qSOFA in comparison to other risk scores, including the CURB-65 and SIRS scores.
In a retrospective analysis, admission data from the ED of the Bern University Hospital, Switzerland, were screened to identify patients admitted for pneumonia. In addition to clinical characteristics, qSOFA and CURB-65 scores and SIRS criteria were assessed and evaluated with respect to the defined study outcomes.
527 patients (median age 66 IQR 50-76) were included in this study. The overall in-hospital mortality was 13.3% (n = 70); 22.0% (n = 116) were transferred to the ICU. The median length of hospitalisation was 7 days (IQR 4-12). In comparison to qSOFA-negative patients, qSOFA-positive patients had increased odds ratios for in-hospital mortality (OR 2.6, 95%:1.4, 4.7, p<0.001) and ICU admission (3.5, 95% CI: 2.0. 5.8, p<0.001) and an increased length of stay (p<0.001). For ICU admission, the specificity of qSOPA-positivity (≥2) was 82.1% and sensitivity 43.0%. For in-hospital mortality, the specificity of qSOPA-positivity (≤2) was 88.9% and sensitivity 24.4%. In the subgroup analysis (n = 366). The area under the receiver operating curve for ICU admission was higher for qSOFA than for the CURB-65 score (p = 0.013). The evaluated scores did not differ significantly in their prognostication of in-hospital mortality (p>0.05).
The qSOFA score is associated with in-hospital mortality, ICU admission and length of hospitalisation in ED patients with pneumonia. Subgroup analysis revealed that qSOFA is superior to CURB-65 in respect to prognostication of ICU admission.</description><subject>Adults</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Comparative analysis</subject><subject>Data processing</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Emergency medical care</subject><subject>Family medical history</subject><subject>Hospitals</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Laboratories</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Patient admissions</subject><subject>Patient 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of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia</title><author>Müller, Martin ; Guignard, Viviane ; Schefold, Joerg C ; Leichtle, Alexander B ; Exadaktylos, Aristomenis K ; Pfortmueller, Carmen A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-c554baac16694c991a53cda98ba9a3215b447480e692485271116f21ceae23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adults</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Blood pressure</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Comparative analysis</topic><topic>Data processing</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Emergency medical care</topic><topic>Family medical history</topic><topic>Hospitals</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Laboratories</topic><topic>Medical diagnosis</topic><topic>Medical research</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Patient admissions</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Prognosis</topic><topic>Risk factors</topic><topic>Sensitivity</topic><topic>Sensitivity analysis</topic><topic>Sepsis</topic><topic>Switzerland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Müller, Martin</creatorcontrib><creatorcontrib>Guignard, Viviane</creatorcontrib><creatorcontrib>Schefold, Joerg C</creatorcontrib><creatorcontrib>Leichtle, Alexander B</creatorcontrib><creatorcontrib>Exadaktylos, Aristomenis K</creatorcontrib><creatorcontrib>Pfortmueller, Carmen A</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central 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One</addtitle><date>2017-12-21</date><risdate>2017</risdate><volume>12</volume><issue>12</issue><spage>e0188913</spage><epage>e0188913</epage><pages>e0188913-e0188913</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Despite on-going advances in medical treatment, the burden of disease of pneumonia remains high. We aimed to determine the association of the qSOFA score with in-hospital mortality, length of hospitalisation, and admission to the intensive care unit (ICU) in patients with pneumonia. Further, in a subgroup analysis, the outcomes were compared for qSOFA in comparison to other risk scores, including the CURB-65 and SIRS scores.
In a retrospective analysis, admission data from the ED of the Bern University Hospital, Switzerland, were screened to identify patients admitted for pneumonia. In addition to clinical characteristics, qSOFA and CURB-65 scores and SIRS criteria were assessed and evaluated with respect to the defined study outcomes.
527 patients (median age 66 IQR 50-76) were included in this study. The overall in-hospital mortality was 13.3% (n = 70); 22.0% (n = 116) were transferred to the ICU. The median length of hospitalisation was 7 days (IQR 4-12). In comparison to qSOFA-negative patients, qSOFA-positive patients had increased odds ratios for in-hospital mortality (OR 2.6, 95%:1.4, 4.7, p<0.001) and ICU admission (3.5, 95% CI: 2.0. 5.8, p<0.001) and an increased length of stay (p<0.001). For ICU admission, the specificity of qSOPA-positivity (≥2) was 82.1% and sensitivity 43.0%. For in-hospital mortality, the specificity of qSOPA-positivity (≤2) was 88.9% and sensitivity 24.4%. In the subgroup analysis (n = 366). The area under the receiver operating curve for ICU admission was higher for qSOFA than for the CURB-65 score (p = 0.013). The evaluated scores did not differ significantly in their prognostication of in-hospital mortality (p>0.05).
The qSOFA score is associated with in-hospital mortality, ICU admission and length of hospitalisation in ED patients with pneumonia. Subgroup analysis revealed that qSOFA is superior to CURB-65 in respect to prognostication of ICU admission.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29267291</pmid><doi>10.1371/journal.pone.0188913</doi><orcidid>https://orcid.org/0000-0003-0326-2770</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adults Analysis Biology and Life Sciences Blood pressure Chronic obstructive pulmonary disease Comparative analysis Data processing Development and progression Diagnosis Emergency medical care Family medical history Hospitals Infections Intensive care Laboratories Medical diagnosis Medical research Medical treatment Medicine Medicine and Health Sciences Mortality Patient admissions Patient outcomes Patients Pneumonia Prognosis Risk factors Sensitivity Sensitivity analysis Sepsis Switzerland |
| title | Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia |
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