Q-SOFA AND NEWS2 SCORES IN SEPSIS PATIENTS ADMITTED TO THE MEDICAL ICU AS PROGNOSTIC MARKERS OF PATIENT OUTCOME: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Introduction: Sepsis is a condition characterized by high levels of morbidity and mortality, most severely affecting critically ill patients, thus early identification and prognostic prediction is essential for improving outcomes. Two instruments frequently used for early identification and prognosis are the quick Sequential Organ Failure Assessment and the National Early Warning Score 2; however, their relative effectiveness in intensive care units has not been clearly established. Methodology: In this prospective observational study, a cohort of 100 adults who were diagnosed with sepsis during the course of the calendar year were included. Their qSOFA and NEWS2 scores were documented upon admission to the Medical Intensive Care Unit (MICU). The primary outcome variable was mortality rate while secondary outcomes included need for mechanical ventilatory support and length of stay in the MICU. The analysis was completed using SPSS Version 24 and receiver operator characteristic (ROC) curves were used to evaluate the predictive performance of each scoring tool. Results: The average age of study participants was 58 years with women making up 65% of the sample. The overall rate of death in patients admitted to an ICU was 38%. There were 46% of patients with a qSOFA score greater than or equal to two who ultimately died (65%) and 52% with a NEWS2 score greater than or equal to seven who ultimately died (70%). NEWS2 had greater sensitivity (82%) and specificity (75%) than qSOFA (68% and 72%, respectively). The area under the curve (AUC) for the NEWS2 score was greater (0.84) than the AUC for the qSOFA score (0.74) using receiver operating characteristics (ROC) analysis. Conclusion: Both scoring systems are valuable for the physician but the NEWS2 system has better predictive accuracy than qSOFA and is more appropriate for risk stratification purposes, whereas qSOFA is intended to serve as a rapid screening tool.