A study of clinico-pathological profile and outcome in patients admitted with sepsis using sequential organ failure assessment and quick sequential organ failure assessment scoring system at a tertiary care centre

Objectives: Organ failure worsens outcome in sepsis. The Sequential Organ Failure Assessment (SOFA) score numerically quantifies the number and severity of failed organs. We examined the utility of the SOFA score for assessing outcome of patients with severe sepsis with evidence of hypoperfusion at the time of emergency department (ED) presentation. Design: Prospective observational study. Interventions: SOFA scores were calculated at ED recognition (T0) and 72 hours after intensive care unit admission (T72). The primary outcome was in-hospital mortality. The area under the receiver operating characteristic curve was used to evaluate the predictive ability of SOFA scores at each time point. The relationship between Δ SOFA (change in SOFA from T0 to T72) was examined for linearity. Results: In the present study, we evaluated distribution of patients according to outcome. It was found that majority of the patients (68%) were discharged from the hospital. 32% of patients were expired during the study. We also compared qSOFA score parameters between admission and 48 hours. At admission, RR was found higher in expired patients (29.63) compared to discharged patients (26.43). At 48 hours, same trend was seen. At admission, SBP was found higher in discharged patients (120.74) compared to expired patients (113.75). At 48 hours, same trend in SBP was noted. GCS was noted higher in discharged patients (11.78) compared to expired patients (9.78) at admission. Same trend at 48 hours was noted in GCS also. Conclusion: During the study. SOFA score increased at 48 hours compared to admission. This difference was statistically significant. qSOFA score decreased at 48 hours compared to admission. This difference was statistically significant.