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Predictive accuracy of the modified SOFA score, SIRS criteria, and qSOFA score for uroseptic shock after

Meng Gao1,2, Zewu Zhu1, Minghui Liu1

  • 1Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China.

Urolithiasis
|February 24, 2022
PubMed

Insights

The modified SOFA (mSOFA) score effectively predicts uroseptic shock after mini-percutaneous nephrolithotomy (mini-PCNL). This score demonstrated superior predictive accuracy compared to SIRS and qSOFA criteria in a recent study.

Area of Science:

  • Urology
  • Critical Care Medicine
  • Medical Diagnostics

Background:

  • Uroseptic shock is a severe complication following minimally invasive urological procedures.
  • Accurate prediction of uroseptic shock is crucial for timely intervention and improved patient outcomes.
  • Existing scoring systems like SIRS and qSOFA have limitations in predicting post-procedural sepsis.

Purpose of the Study:

  • To evaluate the modified SOFA (mSOFA) score's plausibility and utility in predicting uroseptic shock post-mini-percutaneous nephrolithotomy (mini-PCNL).
  • To compare the predictive performance of mSOFA against Systemic Inflammatory Response Syndrome (SIRS) and quick SOFA (qSOFA) scores.

Main Methods:

  • Retrospective analysis of 707 patients undergoing mini-PCNL between August 2019 and December 2020.
  • Calculation and comparison of Area Under the Receiver Operating Characteristic Curve (AUROC) for mSOFA, SIRS, and qSOFA in predicting uroseptic shock.
  • Analysis of patient demographics, pre-operative, and post-operative clinical and laboratory data.

Main Results:

  • 24 out of 707 patients developed uroseptic shock post-mini-PCNL.
  • The mSOFA score showed a higher AUROC (0.866) for predicting uroseptic shock compared to SIRS (0.838) and qSOFA (0.851).
  • Higher rates of positive cultures and elevated inflammatory markers (CRP, PCT) were observed in the uroseptic shock group.

Conclusions:

  • The modified SOFA (mSOFA) score demonstrates superior predictive value for uroseptic shock after mini-PCNL than SIRS or qSOFA.
  • mSOFA can be a valuable tool for early identification and management of patients at risk of uroseptic shock.
  • Further prospective studies are warranted to validate these findings.
Keywords:
ModifiedPercutaneous nephrolithotomySeptic shockSequential organ failure assessment

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