Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings

Li, Andrew and Ling, Lowell and Qin, Hanyu and Arabi, Yaseen M. and Myatra, Sheila Nainan and Egi, Moritoki and Kim, Je Hyeong and Mat Nor, Mohd Basri and Son, Do Ngoc and Fang, Wen-Feng and Wahyuprajitno, Bambang and Hashmi, Madiha and Faruq, Mohammad Omar and Patjanasoontorn, Boonsong and Al Bahrani, Maher Jaffer and Shrestha, Babu Raja and Shrestha, Ujma and Nafees, Khalid Mahmood Khan and Sann, Kyi Kyi and Palo, Jose Emmanuel M. and Mendsaikhan, Naranpurev and Konkayev, Aidos and Detleuxay, Khamsay and Chan, Yiong Huak (2024) Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings. Critical Care, 28 (1). pp. 1-11. ISSN 1364-8535 E-ISSN 1364-8535

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Abstract

Background There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. Methods This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study. Results Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p < 0.001) and UMIC (p < 0.001) and not HIC (p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p < 0.001) and UMIC (p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00–1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h. Conclusions qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions.

Item Type:	Article (Journal)
Uncontrolled Keywords:	qSOFA, APACHE, Prediction, Critical care, Infection, Mortality
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care Kulliyyah of Medicine
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	31 Jan 2024 15:45
Last Modified:	31 Jan 2024 15:57
URI:	http://irep.iium.edu.my/id/eprint/110621

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