• João Gabriel Rosa Ramos, Rogério da Hora Passos, Mauricio Brito Teixeira, Andre Luiz Nunes Gobatto, Rafael Viana Dos Santos Coutinho, Juliana Ribeiro Caldas, Suzete Farias da Guarda, Michel Pordeus Ribeiro, and Batista Paulo Benigno Pena PBP Intensive Care Unit, Hospital Sao Rafael, Salvador, Brazil; Medical School, Escola Bahiana de Medicina, Salvador, Brazil; Medical School, U.
• Intensive Care Unit, Hospital Sao Rafael, Salvador, Brazil; Palliative Care Team, Hospital Sao Rafael, Salvador, Brazil. Electronic address: joao.ramos@hsr.com.br.
• J Crit Care. 2018 Oct 1; 47: 178-184.

ObjectivesSepsis identification in older patients is challenging. We evaluated the performance of qSOFA across different age groups of patients with suspected infection outside the intensive care unit (ICU).MethodsRetrospective cohort in a tertiary hospital in Brazil, from January 2016 to December 2016. Outcomes were hospital mortality, ICU admission and bacteremia. Performance of qSOFA was compared over three age groups: (1) reference: ≤65 years, (2) old: 65 to 79 years and (3) very old: ≥80 years.ResultsThere were 420 patients in the study, of which 259 (61.7%) were ≤65 years, 80 (19%) were 65 to 79 years and 81 (19.3%) were ≥80 years. Old and very old patients had higher qSOFA scores and lower SIRS scores. Overall, qSOFA ≥2 was associated to hospital mortality [OR (95% CI) = 5.8 (3.3-10.4), p < 0.001], ICU admission [OR (95% CI) = 2.7 (1.6-4.6), p < 0.001] and bacteremia [OR (95% CI) = 3.1 (1.7-5.8), p < 0.001]. Those associations were stronger in old and very old patients. qSOFA and SIRS demonstrated overall AUROCs for hospital mortality of 0.72 and 0.50, respectively.ConclusionqSOFA demonstrated good overall accuracy and was more strongly associated to outcomes in old and very old patients, when compared to younger patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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