3 research outputs found
Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings
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
Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study
10.1136/bmj.d3245BMJ-BRITISH MEDICAL JOURNAL342781