The ability of an improved qSOFA score to predict acute sepsis severity and prognosis among adult patients

This study analyzed independent risk factors that could improve the qSOFA scoring system among sepsis patients. This retrospective study evaluated 821 patients (2015–2016) who fulfilled the 2001 International Sepsis Definitions Conference diagnostic criteria. Patients were classified based on their survival outcomes after 28 days, and the predictive values of various predictive scores at admission were compared. The independent risk factors for 28-day mortality were fibrinogen, plasma lactic acid, albumin, oxygenation index, and procalcitonin level >0.5 ng/mL (all P < .05). The “PqSOFA” score combined the qSOFA score with procalcitonin, which provided an area under the curve value of 0.751 (95% CI: 0.712–0.790) for predicting 28-day mortality. A cut-off score of 2 points provided sensitivity of 83.2%, specificity of 54.9%, negative predictive value (NPV) of 33.03%, positive predictive value (PPV) of 92.47%, positive-likelihood ratio (PLR) of 1.85, and negative-likelihood ratio (NLR) of 0.31. The area under the curve for predicting 28-day mortality was significantly greater for the PqSOFA score than for the qSOFA score (Z = 7.019, P < .0001). The PqSOFA score was comparable to the SOFA and APACHE II scores. The PqSOFA score independently predicted poor short-term outcomes among high-risk sepsis patients.