Comparison of Prognostic Accuracy of the quick Sepsis-Related Organ Failure Assessment between Short- & Long-term Mortality in Patients Presenting Outside of the Intensive Care Unit – A Systematic Review & Meta-analysis

Toh Leong Tan, Ying Jing Tang, Ling Jing Ching, Noraidatulakma Abdullah @ Muda, Hui Min Neoh

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Abstract

The purpose of this meta-analysis was to compare the ability of the qSOFA in predicting short- (≤30 days or in-hospital mortality) and long-term (>30 days) mortality among patients outside the intensive care unit setting. Studies reporting on the qSOFA and mortality were searched using MEDLINE and SCOPUS. Studies were included if they involved patients presenting to the ED with suspected infection and usage of qSOFA score for mortality prognostication. Data on qSOFA scores and mortality rates were extracted from 36 studies. The overall pooled sensitivity and specificity for the qSOFA were 48% and 86% for short-term mortality and 32% and 92% for long-term mortality, respectively. Studies reporting on short-term mortality were heterogeneous (Odd ratio, OR = 5.6; 95% CI = 4.6–6.8; Higgins’s I2 = 94%), while long-term mortality studies were homogenous (OR = 4.7; 95% CI = 3.5–6.1; Higgins’s I2 = 0%). There was no publication bias for short-term mortality analysis. The qSOFA score showed poor sensitivity but moderate specificity for both short and long-term mortality, with similar performance in predicting both short- and long- term mortality. Geographical region was shown to have nominal significant (p = 0.05) influence on qSOFA short-term mortality prediction.

Original languageEnglish
Article number16698
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - 1 Dec 2018

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Intensive Care Units
Meta-Analysis
Sepsis
Mortality
Sensitivity and Specificity
Publication Bias
Hospital Mortality
MEDLINE
Odds Ratio

ASJC Scopus subject areas

  • General

Cite this

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abstract = "The purpose of this meta-analysis was to compare the ability of the qSOFA in predicting short- (≤30 days or in-hospital mortality) and long-term (>30 days) mortality among patients outside the intensive care unit setting. Studies reporting on the qSOFA and mortality were searched using MEDLINE and SCOPUS. Studies were included if they involved patients presenting to the ED with suspected infection and usage of qSOFA score for mortality prognostication. Data on qSOFA scores and mortality rates were extracted from 36 studies. The overall pooled sensitivity and specificity for the qSOFA were 48{\%} and 86{\%} for short-term mortality and 32{\%} and 92{\%} for long-term mortality, respectively. Studies reporting on short-term mortality were heterogeneous (Odd ratio, OR = 5.6; 95{\%} CI = 4.6–6.8; Higgins’s I2 = 94{\%}), while long-term mortality studies were homogenous (OR = 4.7; 95{\%} CI = 3.5–6.1; Higgins’s I2 = 0{\%}). There was no publication bias for short-term mortality analysis. The qSOFA score showed poor sensitivity but moderate specificity for both short and long-term mortality, with similar performance in predicting both short- and long- term mortality. Geographical region was shown to have nominal significant (p = 0.05) influence on qSOFA short-term mortality prediction.",
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AU - Neoh, Hui Min

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