Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings

Li A 1 , Ling L 2 , Qin H 3 , Arabi YM 4 , Myatra SN 5 , Egi M 6 Show all authors , Kim JH 7 , Nor MBM 8 , Son DN 9 , Fang WF 10 , Wahyuprajitno B 11 , Hashmi M 12 , Faruq MO 13 , Patjanasoontorn B 14 , Al Bahrani MJ 15 , Shrestha BR 16 , Shrestha U 16 , Nafees KMK 17 , Sann KK 18 , Palo JEM 19 , Mendsaikhan N 20 , Konkayev A 21 , Detleuxay K 22 , Chan YH 23 , Du B 3 , Divatia JV 5 , Koh Y 24 , Phua J 1 , MOSAICS II Study Group , Asian Critical Care Clinical Trials Group

Affiliations 

  • 1 Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
  • 2 Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China. lowell.ling@cuhk.edu.hk
  • 3 State Key Laboratory of Complex, Severe and Rare Disease, Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China
  • 4 King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
  • 5 Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
  • 6 Department of Anesthesiology and Intensive Care, Kyoto University Hospital, Kyoto, Japan
  • 7 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
  • 8 International Islamic University Malaysia Medical Center, Kuantan, Malaysia
  • 9 Center of Critical Care Medicine, Bach Mai Hospital, Hanoi Medical University, VNU University of Medicine and Pharmacy, Hanoi, Vietnam
  • 10 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
  • 11 Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Airlangga, Intensive Care Unit, Dr Soetomo General Hospital, Surabaya, Indonesia
  • 12 Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
  • 13 General Intensive Care Unity and Emergency Department, United Hospital Ltd, Dhaka, Bangladesh
  • 14 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • 15 Department of Anesthesia and Critical Care, Royal Hospital, Muscat, Oman
  • 16 Department of Anesthesia and Intensive Care, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
  • 17 RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
  • 18 Department of Anaesthesiology and ICU, Yangon General Hospital, University of Medicine 1, Yangon, Myanmar
  • 19 Acute and Critical Care Institute, The Medical City, Pasig City, Philippines
  • 20 Mongolia Japan Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
  • 21 Anaesthesiology and Intensive Care Department, Astana Medical University, Astana, Kazakhstan
  • 22 Adult Intensive Care Unit, Mahosot Hospital, Vientiane, Lao PDR
  • 23 Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • 24 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Crit Care, 2024 Jan 23;28(1):30.
PMID: 38263076 DOI: 10.1186/s13054-024-04804-7

Abstract

BACKGROUND: There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions.

METHODS: This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study.

RESULTS: Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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