Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection
Authors: Shannon M. Fernando, Alexandre Tran, Monica Taljaard, Wei Cheng, Jeffrey J. Perry
Journal: Annals of Internal Medicine (2018)

Letters21 August 2018Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected InfectionShannon M. Fernando, MD, MSc, Alexandre Tran, MD, MSc, Monica Taljaard, PhD, Wei Cheng, PhD, and Jeffrey J. Perry, MD, MScShannon M. Fernando, MD, MScUniversity of Ottawa, Ottawa, Ontario, Canada (S.M.F., A.T.)Search for more papers by this author, Alexandre Tran, MD, MScUniversity of Ottawa, Ottawa, Ontario, Canada (S.M.F., A.T.)Search for more papers by this author, Monica Taljaard, PhDUniversity of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (M.T., J.J.P.)Search for more papers by this author, Wei Cheng, PhDOttawa Hospital Research Institute, Ottawa, Ontario, Canada (W.C.)Search for more papers by this author, and Jeffrey J. Perry, MD, MScUniversity of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (M.T., J.J.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0291 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Swartz correctly states that both qSOFA and the SIRS criteria were designed not to diagnose disease but to predict an outcome (1–3). Therefore, use of such criteria by clinicians may alter patient outcomes. Given the retrospective design of many of our included articles, Dr. Swartz implies that clinicians probably routinely used the SIRS criteria but not qSOFA to predict death, because most studies used databases that preceded the publication of the latter. Therefore, patients meeting SIRS criteria may have been more aggressively treated by clinicians and had better outcomes. For this contention to be true, 2 assumptions ...References1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801-10. [PMID: 26903338] doi:10.1001/jama.2016.0287 CrossrefMedlineGoogle Scholar2. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101:1644-55. [PMID: 1303622] CrossrefMedlineGoogle Scholar3. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:762-74. [PMID: 26903335] doi:10.1001/jama.2016.0288 CrossrefMedlineGoogle Scholar4. Rowan KM, Angus DC, Bailey M, Barnato AE, Bellomo R, Canter RR, et al; PRISM Investigators. Early, goal-directed therapy for septic shock—a patient-level meta-analysis. N Engl J Med. 2017;376:2223-34. [PMID: 28320242] doi:10.1056/NEJMoa1701380 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Ottawa, Ottawa, Ontario, Canada (S.M.F., A.T.)University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (M.T., J.J.P.)Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (W.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2820. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection Shannon M. Fernando , Alexandre Tran , Monica Taljaard , Wei Cheng , Bram Rochwerg , Andrew J.E. Seely , and Jeffrey J. Perry Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection Andrew W. Swartz Metrics Cited bySepsis Code in emergency department: Performance of q-SOFA score compared to SIRS scoreActivación del Código Sepsis en urgencias: rendimiento de la escala q-SOFA respecto los criterios SIRSClinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, ChinaTreatment of Renin-Angiotensin-Aldosterone System Dysfunction With Angiotensin II in High-Renin Septic ShockDiagnosing Sepsis: qSOFA is Not the Tool We’re Looking ForUnpacking Prevalence and Dichotomy in Quick Sequential Organ Failure Assessment and Systemic Inflammatory Response Syndrome Parameters: Observational Data–Driven Approach Backed by Sepsis Pathophysiology 21 August 2018Volume 169, Issue 4Page: 264-265KeywordsDisclosureHypotensionMortalityPopulation statisticsQuick sequential organ failure assessmentRetrospective studiesSepsisShockSystematic reviewsTachypnea ePublished: 21 August 2018 Issue Published: 21 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...