Frequency and significance of qSOFA criteria during adult rapid response team reviews: A prospective cohort study

Maurice LeGuen, Yvonne Ballueer, Richard McKay, Glenn Eastwood, Rinaldo Bellomo, Daryl Jones, The Austin Health RRT qSOFA investigators, Michelle Topple, Tammie McIntyre, Carmel Taylor, Damien Blythe, Brooke Ryan, Najeea Ali, Toby Jeffcote, Sadie O’Callahan, Mark Kubicki, Neil Glassford, Boris Tseitkin, Timothy Ho, Wisam Al-BassamRahul Costa-Pinto, Kelvin Kuik, Scott May, Jeremy Broad, Chuan Tai Foo, Michelle Grigoriadis, James Bennett, Karen McCrohan, Melissa Gloster, Merryn Barker, Mary Larsen, William Tui, Cathy Young, Clair Osborne, Sandra Moore, Brian Shortal, Penny Ashworth, Lisa Fuhrmeister, Craig Lesom, Tony King, Alison Rose, Robyn Best, Kristy Ross, Lyndal Fawcett, Meagan Delaney, Melissa Butterworth, Melisa Bu, Been Cherian, Jayne Ramsdale, Renee Bartlett, Carmel Walsh, Kate Dixon, Abbey Littlepage, Valerie Liambos, Margaret Holley, Catherine Campbell, Deirdre Nion, Michelle Baxter, Mee Cheng, Monica Dowling, Craig Elsom

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26 Citations (Scopus)

Abstract

Aim A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes. Methods We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia Results Over a one-month period, there were 282 RRT reviews, 258 of which were included. One hundred out of 258 (38.8%) RRT review patients fulfilled qSOFA criteria. qSOFA positive patients were more likely to be admitted to the intensive care unit (29% vs 18%, P = 0.04), to have repeat RRT reviews (27% vs 13%; p = 0.007) and die in hospital (31% vs 10%, P < 0.001). qSOFA positive patients with suspected infection were more likely to be admitted to the intensive care unit compared to patients with infection alone (37% vs 15%, P = 0.002). Eleven of 42 patients (26%) who had infection and qSOFA died whilst in hospital, compared to 8/55 (15%) of patients with infection alone (P = 0.2). Conclusion Adult patients who are qSOFA positive at the time of their RRT review are at increased risk of in-hospital mortality. The assessment of qSOFA may be a useful triage tool during a RRT review.

Original languageEnglish
Pages (from-to)13-18
Number of pages6
JournalResuscitation
Volume122
DOIs
Publication statusPublished - Jan 2018

Keywords

  • Infection
  • qSOFA
  • RRT call
  • Sepsis
  • SOFA

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