Objective The quick sequential organ failure assessment (qSOFA) score, which includes mentation, systolic blood pressure, and respiratory rate, was developed to identify serious sepsis in out-of-hospital or emergency department (ED) settings. We evaluated the ability of the qSOFA score to predict poor outcome in South Korean ED patients with suspected infection.
Methods The qSOFA score was calculated for adult ED patients with suspected infection. Patients who received intravenous or oral antibiotics in the ED were considered to have infection. In-hospital mortality rate, admission rate, intensive care unit (ICU) admission rate, length of hospital stay (LOS), and lactate levels were compared between the qSOFA score groups. Receiver operating characteristic curves and area under the receiver operating characteristic curve values for in-hospital mortality were calculated according to qSOFA cut-off points and lactate levels.
Results Of 2,698 patients, in-hospital mortality occurred in 134 (5.0%). The mortality rate increased with increasing qSOFA score (2.2%, 6.4%, 17.5%, and 42.4% for qSOFA scores 0, 1, 2, and 3, respectively, P<0.001). The admission rate, ICU admission rate, LOS, and lactate level also increased with increasing qSOFA score (all P<0.001). The area under the receiver operating characteristic curve values for predicting in-hospital mortality associated with qSOFA score, lactate ≥2 mmol/L, and lactate ≥4 mmol/L were 0.719 (95% confidence interval [CI], 0.670 to 0.768), 0.657 (95% CI, 0.603 to 0.710), and 0.632 (95% CI, 0.571 to 0.693), respectively.
Conclusion Patients with a higher qSOFA score had higher admission, ICU admission, and in-hospital mortality rates, longer LOS, and higher lactate level. The qSOFA score showed better performance for predicting poor outcome than lactate level.
Citations
Citations to this article as recorded by
Clinical utility of biomarkers for outcomes prediction in adults with suspected sepsis presenting to the emergency department: a synthesis of current evidence Mari Imamura, Sinead N Duggan, Thenmalar Vadiveloo, Jamie G Cooper, Callum T Kaye, Paul Manson, Gianni Virgili, Lorna Aucott, Mike Clarke, Miriam Brazzelli Health Technology Assessment.2026; : 1. CrossRef
Outcome-Specific Prognostic Performance of Pneumonia Severity Assessment Tools for Predicting a Spectrum of Multiple Clinical Events Abuzer Özkan, Ahmet Taha Özatak, Soner Yeşilyurt Bratislava Medical Journal.2026; 127(8): 3712. CrossRef
The Role of qSOFA, Derived Neutrophil-to-Lymphocyte Ratio, MEWS, and PIRO Scores in Predicting the Severity of Odontogenic Infections in Young and Adult Patients Serban Talpos Niculescu, Robert Avramut, Tareq Hajaj, Raluca Maracineanu, Antonis Perdiou, Roxana Talpos Niculescu, Marius Pricop, Horatiu Urechescu, Florin Urtila, Roxana Radu, Nicoleta Nikolajevic Stoican, Malina Popa Biomedicines.2025; 13(3): 532. CrossRef
Sodium level in patients with sepsis: what is the predictive value? Zain Sayed, Ahmed A. Obiedallah, Soheir M. Kasem, Abdelraouf M.S. Abdelraouf, Kareem S.M. Ismail, Alaa O. Ahmed Research and Opinion in Anesthesia & Intensive Care.2025; 12(1): 35. CrossRef
Lactate Enhanced Quick Sequential Organ Failure Assessment Score (Lqsofa) as a Tool to Predict the Prognosis in Patients of Sepsis in Surgical Intensive Care Unit Akash Sharma, Nitin Garg, Rahul Patel, Pooja Sharma International Journal of Recent Surgical and Medical Sciences.2025; 11: e015. CrossRef
Comparative analysis of Glasgow Coma Scale, quick Sepsis-related Organ Failure Assessment, base excess, and lactate for mortality prediction in critically ill emergency department patients Gürbüz Meral, Şenol Ardıç, Serkan Günay, Kadir Güzel, Ahmet Köse, Hülya Gençbay Durmuş, Serhat Uysal, Aydın Coşkun Turkish Journal of Emergency Medicine.2024; 24(4): 231. CrossRef
First
Prev
