Diagnostic Accuracy of Lactate, SOFA and qSOFA Scores as Predictors of Mortality in Sepsis and Septic Shock
AbstractThis study aims to assess the accuracy of serum lactate levels, SOFA and qSOFA scores as prognostic indicators of mortality in sepsis patients, and to compare their accuracy in our population and setting.
MethodsThis retrospective cohort study assessed all adult patients hospitalized at the Aga Khan University Hospital from October 2019 and December 2019 with the diagnosis of sepsis. Data of the included patients was collected from medical records and extracted variables included demographics, patient and hospitalization characteristics, laboratory investigations and outcome.
Results  Three hundred and sixty-six patients were admitted during the study period with the diagnosis of sepsis. There were 208 (57%) males and 158 (43%) females; mean age was 59 ± 18 years. Overall mortality in sepsis was 25% and mean length of stay was 7.5 ± 6.2 days. The AUROC of serum lactate for predicting mortality was 0.79 with 81% sensitivity and 64% specificity. Furthermore, the AUROC of SOFA for predicting mortality was 0.54 with 60% sensitivity and 43% specificity in comparison to the AUROC of qSOFAscore which was 0.49 with 54% sensitivity and 48% specificity.
Conclusion  In our sepsis patients, serum lactate levels were more reliably associated with mortality; qSOFA and SOFA scores had low sensitivity and specificity as mortality predictors. Further large-scale studies are needed in our population to determine the utility and reliability of these tools.
Keywords:sepsis; lactate; SOFA; qSOFA; sensitivity and specificity.
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