• Yohei Kamikawa, Hiroyuki Hayashi, Jeffrey N Bone, and Ran D Goldman.
• Department of Emergency Medicine, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan. fundarike.ykami@gmail.com.
• Intern Emerg Med. 2024 Dec 5.

AbstractThe National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (qSOFA), and modified qSOFA (MqSOFA) are scoring systems that rely on vital signs. However, NEWS is time-consuming, qSOFA has low sensitivity, and MqSOFA includes a difficult calculation. To address these issues, we developed the Revised qSOFA score (RqSOFA) that consists of percutaneous oxygen saturation, oxygen usage, Simple Shock Index, and the parameters of qSOFA. The predictability of RqSOFA was examined for in-hospital mortality among patients who were transported by ambulance. This observational cohort study included all patients transported via ambulance to an Emergency Department between 2019 and 2021. Patients who had prehospital cardiopulmonary arrest, were pregnant, were younger than 15 years old, arrived from another hospital, and had missing data were excluded. The Area Under the Receiver Operating Characteristic curve (AUROC) of RqSOFA, as well as its sensitivity and specificity at the optimal cut-off point, were determined and compared to those of qSOFA, NEWS and MqSOFA. Among 1849 included patients, 53 died in the hospital. The AUROC for RqSOFA was 0.867 and the optimal cut-off point was 2. The sensitivity and specificity were 0.849 and 0.802, respectively. The AUROC of RqSOFA was larger than qSOFA but had no significance with NEWS and MqSOFA. RqSOFA exhibited the same sensitivity and better specificity compared to NEWS. There were no differences in sensitivity and specificity between RqSOFA and MqSOFA. In conclusion, RqSOFA exhibited superior predictability for in-hospital mortality to qSOFA and NEWS, while offering similar predictability to MqSOFA despite relying only on simple measurements.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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