Prognostic ability of quick-SOFA across different age groups of patients with suspected infection outside the intensive care unit: A cohort study


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Abstract

Objectives:Sepsis identification in older patients is challenging. We evaluated the performance of qSOFA across different age groups of patients with suspected infection outside the intensive care unit (ICU).Methods:Retrospective cohort in a tertiary hospital in Brazil, from January 2016 to December 2016. Outcomes were hospital mortality, ICU admission and bacteremia. Performance of qSOFA was compared over three age groups: (1) reference: ≤65 years, (2) old: 65 to 79 years and (3) very old: ≥80 years.Results:There were 420 patients in the study, of which 259 (61.7%) were ≤65 years, 80 (19%) were 65 to 79 years and 81 (19.3%) were ≥80 years. Old and very old patients had higher qSOFA scores and lower SIRS scores. Overall, qSOFA ≥2 was associated to hospital mortality [OR (95% CI) = 5.8 (3.3–10.4), p < 0.001], ICU admission [OR (95% CI) = 2.7 (1.6–4.6), p < 0.001] and bacteremia [OR (95% CI) = 3.1 (1.7–5.8), p < 0.001]. Those associations were stronger in old and very old patients. qSOFA and SIRS demonstrated overall AUROCs for hospital mortality of 0.72 and 0.50, respectively.Conclusion:qSOFA demonstrated good overall accuracy and was more strongly associated to outcomes in old and very old patients, when compared to younger patients.HighlightsqSOFA demonstrated good overall accuracy and was more strongly associated to outcomes in older age groups.SIRS criteria were not predictive of outcomes in this population.There were different vital signs alterations in each age group.Older age was associated with worse outcomes.

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