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The following is a summary of “Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings,” published in the January 2024 issue of Critical Care by Li et al.

Researchers started a retrospective study to investigate the global association between quick sequential organ failure assessment (qSOFA) and mortality rates at 3, 28, and 90 days in ICU patients with sepsis across low and lower/upper middle-income (LLMIC/UMIC) and high-income (HIC) countries.

They performed a secondary analysis of the MOSAICS II study, an international prospective observational study focusing on sepsis epidemiology in Asian ICUs. Studied qSOFA at ICU admission and mortality associations separately in LLMIC, UMIC, and HIC regions. Using modified Poisson regression, the relative risk (RR) of qSOFA scores was calculated on 28-day mortality, considering confounders identified in the MOSAICS II study.

The results showed a secondary analysis of the MOSAICS II study cohort involving 4,980 patients, with 4,826 patients from 343 ICUs across 22 countries. Higher qSOFA levels were linked to increased 28-day mortality, observed in LLMIC (P<0.001) and UMIC (P<0.001) but not in HIC (P=0.220) countries/regions. Similarly, elevated 90-day mortality was associated with increased qSOFA in LLMIC (P<0.001) and UMIC (P<0.001) exclusively. Conversely, heightened 3-day mortality with an increasing qSOFA score was observed across all income countries/regions (P<0.001).QSOFA remained linked to 28-day mortality (adjusted RR 1.09, P=0.038) in multivariate analysis, even after accounting for variables such as APACHE II, SOFA, income country/region, and antibiotic administration within 3 hours.

They concluded that the qSOFA score globally predicted early death in sepsis patients, but its link to later death weakened in wealthier countries.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04804-7