Efficacy and accuracy of qSOFA and SOFA scores as prognostic tools for community-acquired and healthcare-associated pneumonia. (July 2019)

• Record Type: Journal Article
• Authors: Asai, Nobuhiro; Watanabe, Hiroki; Shiota, Arufumi; Kato, Hideo; Sakanashi, Daisuke; Hagihara, Mao; Koizumi, Yusuke; Yamagishi, Yuka; Suematsu, Hiroyuki; Mikamo, Hiroshige
• Is Part Of: International journal of infectious diseases. Volume 84(2019)
• Page Start: 89
• Page End: 96
• Publication Date: 2019-07
• Subjects: qSOFA -- SOFA score -- Community-acquired pneumonia -- Healthcare-associated pneumonia; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2019.04.020
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: The Japanese Respiratory Society recently updated the prognostic guidelines for pneumonia in 2017. The new guidelines recommend that pneumonia severity be evaluated using the sequential organ failure assessment (SOFA) and the quick SOFA (qSOFA) scoring systems in a therapeutic strategy flowchart. The combination of qSOFA and SOFA score could be an independent prognostic factor for 30-day mortality among patients with community-onset pneumonia. Abstract: Background: The Japanese Respiratory Society recently updated its prognostic guidelines for pneumonia, recommending that pneumonia severity be evaluated using the sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) scoring systems in a therapeutic strategy flowchart. However, the efficacy and accuracy of these tools are still unknown. Methods: All patients with community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) who were admitted to the study institution between 2014 and 2017 were enrolled in this study. Pneumonia severity on admission was evaluated by A-DROP, CURB-65, PSI, I-ROAD, qSOFA, and SOFA scoring systems. Prognostic factors for 30-day mortality were also analyzed. Results: This study included 406 patients, 257 male (63%) and 149 female (37%). The median age was 79 years (range 19–103 years). The 30-day and in-hospital mortality rates were both 5%. With respect to the diagnostic value of the predictive assessments for 30-day mortality, the area under the receiver operating characteristic curve (AUROC) value for the SOFA score was 0.769 for CAP patients and 0.774 for HCAP patients. Further, the AUROC values for the SOFA score in CAP and HCAP patients with a qSOFA score ≥2 were 0.829 and 0.784, respectively, for 30-day mortality. Conclusions: qSOFA and SOFA scores were able to correctly evaluate the severity of CAP and HCAP.