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Utility of Sequential Organ Failure Assessment score in predicting bacteremia in critically ill burn patients
Husayn A Ladhani1, Nitin Sajankila1, Brenda M Zosa1
1Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA; Case Western Reserve University, School of Medicine, 2109 Adelbert Road, Cleveland, OH, 44106, USA.
Background:
We evaluated whether qSOFA ≥2 and an increase in SOFA (ΔSOFA) ≥2 can help predict bacteremia in a critically ill burn population.
Methods:
Patients age ≥15 and TBSA ≥15% admitted between 2009 and 2015 were included. All blood cultures were recorded, and positive and negative blood culture days were defined based on the culture results. SOFA and qSOFA scores were compared between positive and negative blood culture days.
Results:
There were 50 patients in our study with a mean age of 47yrs and mean TBSA burn of 37%. Bacteremic patients had larger TBSA and full thickness burns, higher revised Baux score, and longer hospital LOS, without a difference in mortality, compared to non-bacteremic patients. There was no difference in qSOFA and SOFA scores between positive and negative blood culture days. A ΔSOFA ≥5 was highly specific for positive blood culture days.
Conclusions:
SOFA and qSOFA have limited ability to predict bacteremia in critically ill burn patients.
Insights
In critically ill burn patients, quick Sequential Organ Failure Assessment (qSOFA) scores and Sequential Organ Failure Assessment (SOFA) score increases showed limited ability to predict bacteremia. A significant increase in SOFA score (ΔSOFA ≥5) was highly specific for positive blood cultures.
Area of Science:
- Critical care medicine
- Burn injury research
- Infectious disease diagnostics
Background:
- Bacteremia is a serious complication in critically ill burn patients.
- Predictive tools for bacteremia in this population are crucial for timely intervention.
- The utility of SOFA and qSOFA scores in predicting bacteremia in burn patients requires further investigation.
Purpose of the Study:
- To evaluate the predictive capability of qSOFA ≥2 and ΔSOFA ≥2 for bacteremia in critically ill burn patients.
- To compare SOFA and qSOFA scores between bacteremic and non-bacteremic patient groups.
Main Methods:
- Retrospective analysis of 50 critically ill burn patients (age ≥15, TBSA ≥15%) admitted between 2009-2015.
- Comparison of SOFA and qSOFA scores on positive versus negative blood culture days.
- Assessment of the specificity and sensitivity of SOFA and qSOFA score changes (ΔSOFA) for predicting bacteremia.
Main Results:
- Bacteremic patients exhibited larger TBSA, full-thickness burns, higher revised Baux scores, and longer hospital stays, but similar mortality rates.
- No significant difference was observed in SOFA or qSOFA scores between positive and negative blood culture days.
- A ΔSOFA ≥5 demonstrated high specificity for identifying positive blood culture days.
Conclusions:
- SOFA and qSOFA scores have limited utility in predicting bacteremia in critically ill burn patients.
- While not predictive on their own, a substantial increase in SOFA score (ΔSOFA ≥5) shows potential as a specific indicator for bacteremia in this cohort.
