| Author | Machado, Flavia R. | |
| Author | Cavalcanti, Alexandre B. | |
| Author | Monteiro, Mariana B. | |
| Author | Sousa, Juliana L. | |
| Author | Bossa, Aline | |
| Author | Bafi, Antonio T. | |
| Author | Dal-Pizzol, Felipe | |
| Author | Freitas, Flavio G. R. | |
| Author | Lisboa, Thiago | |
| Author | Westphal, Glauco A. | |
| Author | Japiassu, Andre M. | |
| Author | Azevedo, Luciano C. P. | |
| Access date | 2020-06-04T21:22:50Z | |
| Available date | 2020-06-04T21:22:50Z | |
| Document date | 2020 | |
| Citation | MACHADO, Flavia R. et al. Predictive Accuracy of the Quick Sepsis-related Organ Failure Assessment Score in Brazil. A Prospective Multicenter Study. American Journal of Respiratory and Critical Care Medicine, v. 201, n. 7, p. 789-798, 2020. | pt_BR |
| ISSN | 1073-449X | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/41545 | |
| Description | Andre Miguel Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Centro de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. | pt_BR |
| Language | eng | pt_BR |
| Publisher | American Thoracic Society | pt_BR |
| Rights | restricted access | pt_BR |
| Title | Predictive Accuracy of the Quick Sepsis-related Organ Failure Assessment Score in Brazil. A Prospective Multicenter Study | pt_BR |
| Type | Article | |
| DOI | 10.1164/rccm.201905-0917OC | |
| Abstract | Rationale: Although proposed as a clinical prompt to sepsis based on predictive validity for mortality, the Quick Sepsis-related Organ Failure Assessment (qSOFA) score is often used as a screening tool, which requires high sensitivity.Objectives: To assess the predictive accuracy of qSOFA for mortality in Brazil, focusing on sensitivity.Methods: We prospectively collected data from two cohorts of emergency department and ward patients. Cohort 1 included patients with suspected infection but without organ dysfunction or sepsis (22 hospitals: 3 public and 19 private). Cohort 2 included patients with sepsis (54 hospitals: 24 public and 28 private). The primary outcome was in-hospital mortality. The predictive accuracy of qSOFA was examined considering only the worst values before the suspicion of infection or sepsis.Measurements and Main Results: Cohort 1 contained 5,460 patients (mortality rate, 14.0%; 95% confidence interval [CI], 13.1-15.0), among whom 78.3% had a qSOFA score less than or equal to 1 (mortality rate, 8.3%; 95% CI, 7.5-9.1). The sensitivity of a qSOFA score greater than or equal to 2 for predicting mortality was 53.9% and the 95% CI was 50.3 to 57.5. The sensitivity was higher for a qSOFA greater than or equal to 1 (84.9%; 95% CI, 82.1-87.3), a qSOFA score greater than or equal to 1 or lactate greater than 2 mmol/L (91.3%; 95% CI, 89.0-93.2), and systemic inflammatory response syndrome plus organ dysfunction (68.7%; 95% CI, 65.2-71.9). Cohort 2 contained 4,711 patients, among whom 62.3% had a qSOFA score less than or equal to 1 (mortality rate, 17.3%; 95% CI, 15.9-18.7), whereas in public hospitals the mortality rate was 39.3% (95% CI, 35.5-43.3).Conclusions: A qSOFA score greater than or equal to 2 has low sensitivity for predicting death in patients with suspected infection in a developing country. Using a qSOFA score greater than or equal to 2 as a screening tool for sepsis may miss patients who ultimately die. Using a qSOFA score greater than or equal to 1 or adding lactate to a qSOFA score greater than or equal to 1 may improve sensitivity. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Instituto Latino-Americano de Sepsis. São Paulo, SP, Brasil. | pt_BR |
| Subject | Quick Sepsis-related Organ Failure Assessment | pt_BR |
| Subject | Sepsis-related Organ Failure Assessment | pt_BR |
| Subject | Organ dysfunction | pt_BR |
| Subject | Sepsis | pt_BR |
| Subject | Systemic inflammatory response syndrome | pt_BR |
| Embargo date | 2021-06-01 | |
