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Age-adjusted quick Sequential Organ Failure Assessment score for predicting mortality and disease severity in

Sohyun Eun1, Haemin Kim1, Ha Yan Kim2

  • 1Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.

Scientific Reports
|November 5, 2021
PubMed

Insights

The age-adjusted quick Sequential Organ Failure Assessment (qSOFA) score shows moderate accuracy in predicting mortality and disease severity in infected children. While helpful for identifying at-risk youth, its sensitivity may limit clinical utility.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Diagnostic accuracy studies

Background:

  • Sepsis is a leading cause of mortality in children.
  • Early identification of severe illness is crucial for timely intervention.
  • The quick Sequential Organ Failure Assessment (qSOFA) score is used to assess sepsis severity, but its performance in pediatric populations requires further evaluation.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of the age-adjusted quick Sequential Organ Failure Assessment (qSOFA) score for predicting mortality and disease severity in pediatric patients with suspected or confirmed infection.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed, EMBASE, Cochrane Library, Web of Science).
  • A meta-analysis was conducted on data from eleven studies, including a total of 172,569 pediatric patients.
  • Diagnostic accuracy metrics, including pooled sensitivity, specificity, and diagnostic odds ratio, were calculated.

Main Results:

  • The age-adjusted qSOFA demonstrated moderate predictive power for both mortality (sensitivity 0.73, specificity 0.63) and disease severity (sensitivity 0.73, specificity 0.72).
  • The area under the summary receiver-operating characteristic curve was 0.733, indicating moderate overall performance.
  • Predictive performance was notably better in emergency department settings compared to intensive care units.

Conclusions:

  • The age-adjusted qSOFA is a useful tool for the rapid identification of pediatric patients at risk of severe outcomes from infection.
  • However, its moderate sensitivity suggests that it should be used in conjunction with clinical judgment and other diagnostic tools.
  • Further research may be needed to refine scoring systems for improved accuracy in pediatric sepsis prediction.

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