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sequential organ failure assessment (SOFA, quick or qSOFA)

Indications: - assessment of sepsis & septic shock - qSOFA score identifies hospitalzed patients with infection at risk of death in low-income countries [3] Clinical significance: - a qSOFA score >=2 suggests poor prognosis - for patients who require mechanical ventilation, age predicts mortality better than SOFA score [4] * qSOFA has poor sensitivity & moderate specificity for short-term mortality [2]

General

clinical procedure

References

  1. Freund Y, Lemachatti N, Krastinova E et al. Prognostic accuracy of Sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA 2017 Jan 17; 317:301. http://jamanetwork.com/journals/jama/article-abstract/2598268 - Raith EP, Udy AA, Bailey M et al. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA 2017 Jan 17; 317:290. http://jamanetwork.com/journals/jama/article-abstract/2598267 - Lamontagne F, Harrison DA, Rowan KM. qSOFA for identifying sepsis among patients with infection. JAMA 2017 Jan 17; 317:267. PMID: 28114531
  2. Fernando SM, Tran A, Taljaard M et al. Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection: A systematic review and meta-analysis. Ann Intern Med 2018 Feb 20; 168:266. PMID: 29404582 http://annals.org/aim/article-abstract/2671919/prognostic-accuracy-quick-sequential-organ-failure-assessment-mortality-patients-suspected - Singer M, Shankar-Hari M. qSOFA, cue confusion. Ann Intern Med 2018 Feb 20; 168:293. PMID: 29404580 http://annals.org/aim/article-abstract/2671920/qsofa-cue-confusion?doi=10.7326%2fM17-3415
  3. Rudd KE, Seymour CW, Aluisio AR et al Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries. JAMA. Published online May 20, 2018 PMID: 29800114 https://jamanetwork.com/journals/jama/fullarticle/2681801 - Adhikari NKJ, Rubenfeld GD qSOFA Score for Patients With Sepsis in Low- and Middle-Income Countries. JAMA. Published online May 20, 2018 PMID: 29800023 https://jamanetwork.com/journals/jama/fullarticle/2681800
  4. Raschke RA et al. Discriminant accuracy of the SOFA score for determining the probable mortality of patients with COVID-19 pneumonia requiring mechanical ventilation. PMID: 33595630 PMCID: PMC7890534 (available on 2021-08-17) JAMA 2021 Feb 17; https://jamanetwork.com/journals/jama/fullarticle/2776737
  5. qSOFA (Quick SOFA Score) for Sepsis Identification https://www.mdcalc.com/qsofa-quick-sofa-score-sepsis-identification