• Andrew Li, Lowell Ling, Hanyu Qin, Yaseen M Arabi, Sheila Nainan Myatra, Moritoki Egi, Je Hyeong Kim, NorMohd Basri MatMBMInternational Islamic University Malaysia Medical Center, Kuantan, Malaysia., Do Ngoc Son, Wen-Feng Fang, Bambang Wahyuprajitno, Madiha Hashmi, Mohammad Omar Faruq, Boonsong Patjanasoontorn, Maher Jaffer Al Bahrani, Babu Raja Shrestha, Ujma Shrestha, Khalid Mahmood Khan Nafees, Kyi Kyi Sann, PaloJose Emmanuel MJEMAcute and Critical Care Institute, The Medical City, Pasig City, Philippines., Naranpurev Mendsaikhan, Aidos Konkayev, Khamsay Detleuxay, Yiong Huak Chan, Bin Du, Jigeeshu Vasishtha Divatia, Younsuck Koh, Jason Phua, MOSAICS II Study Group, and Asian Critical Care Clinical Trials Group.
• Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore.
• Crit Care. 2024 Jan 23; 28 (1): 3030.

BackgroundThere 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.MethodsThis 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.ResultsAmong 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 < 0.001) and UMIC (p < 0.001) and not HIC (p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p < 0.001) and UMIC (p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00-1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h.ConclusionsqSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions.© 2024. The Author(s).

13 keywords...

hide…