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J Crit Care. 2018 Jun;45:52-57. doi: 10.1016/j.jcrc.2017.12.024. Epub 2018 Jan 4.

Accuracy of SOFA, qSOFA, and SIRS scores for mortality in cancer patients admitted to an intensive care unit with suspected infection.

Author information

1
ICU, AC Camargo Cancer Center, São Paulo, R. Prof. Antônio Prudente, 211 Liberdade, São Paulo, SP 01509-010, Brazil. Electronic address: ramonteixeiracosta@gmail.com.
2
ICU, AC Camargo Cancer Center, São Paulo, R. Prof. Antônio Prudente, 211 Liberdade, São Paulo, SP 01509-010, Brazil; Discipline of Clinical Emergency, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Av. Dr. Enéas de Carvalho Aguiar, 255 Cerqueira César, São Paulo, SP 05403-000, Brazil.
3
ICU, AC Camargo Cancer Center, São Paulo, R. Prof. Antônio Prudente, 211 Liberdade, São Paulo, SP 01509-010, Brazil; Pulmonary Division, Heart Institute (Incor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44 Pinheiros, São Paulo, SP 05403-900, Brazil.

Abstract

PURPOSE:

To compare the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) with systemic inflammatory response syndrome (SIRS) criteria in critically ill cancer patients with suspected infection.

METHODS:

Data for 450 cancer patients admitted to an intensive care unit (ICU) in 2014 with a suspected infection were retrospectively analyzed. Sensitivity, specificity, and area under the receiver operating curve (AUC) values for SOFA, qSOFA, and SIRS criteria for ICU and hospital mortalities were calculated. Mortalities according to Sepsis-2 stratification (e.g., sepsis, severe sepsis, and septic shock) and Sepsis-3 stratification (e.g., infection, sepsis, and septic shock) were also compared.

RESULTS:

SOFA outperformed SIRS in predicting mortalities for ICU [(AUC, 0.76; 95% confidence interval (CI) 95%, 0.71-0.81) vs. (AUC, 0.62; 95% CI, 0.56-0.67), p < .01] and hospital [(AUC, 0.69; 95% CI, 0.65-0.74) vs. (AUC, 0.58; 95% CI, 0.52-0.63), p < .01)] patients. Similarly, qSOFA outperformed SIRS for both settings [(AUC, 0.71; 95% CI, 0.65-0.76, p = .02) vs. (AUC, 0.69; 95% CI, 0.64-0.74; p < .01), respectively].

CONCLUSIONS:

SOFA and qSOFA were more sensitive and accurate than SIRS in predicting ICU and hospital mortality for critically ill cancer patients with suspected infection.

KEYWORDS:

Cancer; Intensive care unit; Mortality; Organ dysfunction; Sepsis

PMID:
29413723
DOI:
10.1016/j.jcrc.2017.12.024

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