Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Introduction: Sepsis is defined as a life-threatening organ dysfunction due to an inflammatory immune response triggered by an infection. In 2016, a shortened sequential organ failure assessment score (SOFA score), known as the quick SOFA score (qSOFA), replaced the SIRS system of diagnosis. Objective: The aim of our work was to investigate the validity of qsofa in predicting outcome of patients with sepsis in the emergency department. Methods: This prospective comparative study was be conducted on 100 patients from august 2017 to august 2018, with sepsis and evidence of Multi-Organ Failure (MOF) at the time of emergency department presentation, who were admitted to the critical care department, Cairo University, Egypt to evaluate the quick Sequential Organ Failure Assessment score for predicting Outcome in septic patients. RESULTS: The mean age of all patients was (67.55 ± 13.3) year and the majority (74%) of patients were males. The predominant cause of sepsis was pneumonia (87%). Multiple regression analysis showed that qSOFA at day-0 had an independent effect on increasing organ dysfunction (p < 0.05 respectively). The overall mortality was 32%. By using ROC-curve analysis, qSOFA score at day-0 predicted patients mortality, with poor accuracy, sensitivity= 43% and specificity= 70% (p = 0.042). SOFA score at day-1 predicted patients mortality, with good accuracy, sensitivity= 84% and specificity= 76% (p < 0.01). APACHEII score predicted patients mortality, with good accuracy, sensitivity= 87% and specificity= 72% (p < 0.01). Conclusion: qSOFA at admission is a useful predictor of sepsis and evidence of multi-organ failure in critically ill patients in ED. qSOFA had poor sensitivity and moderate specificity for short-term mortality

Issued also as CD