Title: Association of Quick Sepsis-Related Organ Failure Assessment (qSOFA) to predict Severity in Patients with Pneumonia

Authors: Dr Rajeev H, Dr Hilas, Dr Tharuni latha, Dr Preethi Gandhi, Dr Anila Jose, Dr Gururaj V Gunda

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.120

Abstract

Background: qSOFA is generally useful in predicting the outcome in populations in the general emergency department (ED) in sepsis and most common types of infections to cause sepsis are respiratory like pneumonia or genitourinary like a urinary tract infection. In this study we are evaluating whether qSOFA can predict severity in pneumonia patients during initial assessment.

Aims & Objectives: To evaluate the association of the qSOFA score to predict admission to the intensive care unit (ICU) and length of hospital stay in patients with pneumonia.

Method: This retrospective study was done at Kempegowda Institute of Medical Sciences and Research Centre, Bengaluru in the Department of Medicine. A total of 50 patients admitted for pneumonia were screened and the qSOFA score was calculated according to initial assessment data, further the admission status and length of stay was also recorded for study.

Results: A total of 50 patients were included in the study out of which 30(60%) male and 20 (40%) female patients and the male to female ratio was 1.5:1.Mean age of the participants was 56.60 years. Women subjects were five years younger than males with little variation in dispersion (SD). All the patients had fever and cough with expectoration at the time of presentation. Confusion or disorientation was noticed among 36% of the patients at presentation. It was observed that with increasing qSOFA score disorientation and pulmonary complications tend to increase. All those who needed ICU care had a score of 2 or more and there was significantly increased duration of hospitalization with qSOFA more than 2 (15 days more in score 3 compared to score 1). qSOFA score predictability in ICU admission showed sensitivity of 100% and specificity of 35.5% with positive predictive value of 75% and negative predictive value of 100%.

Conclusion: qSOFA score showed good predictive performance for ICU admission and in assessing the duration of stay in hospital and hence the severity of pneumonia.

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Corresponding Author

Dr Rajeev H

Professor of Department of General Medicine, KIMS Banglore