Study of Clinical Course and Outcome in Patients Admitted with Sepsis using ‘SOFA and qSOFA’ Scoring Systems at a Tertiary Care Centre

Introduction: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The task force in the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) formulated the SOFA score based on six parameters of respiration, coagulation, liver, central nervous system, kidneys and cardiovascular systems representing the major organs of the body. A new score, the qSOFA score (q for quick) was formulated using respiratory rate, systolic blood pressure and altered sensorium. This score was intended to be used at the bedside and without laboratory investigations. Aims and Objectives: To study the clinical course & outcome in patients admitted with sepsis using ‘sofa & qsofa’ scoring systems at a tertiary care centre. Materials and Methods: This is a prospective observational study, done between a periods between August 2017 to December 2019 in patients admitted to the Medical Intensive Care Unit of a tertiary care hospital. The total number of patients studied was 180. The SOFA and qSOFA scores were calculated for each patient on admission and after 72 hours. The comorbidities like diabetes and hypertension were also recorded. The clinical features and outcome was correlated with the SOFA and the qSOFA scores. Results: There were 31 deaths (17.22%) out of a total of 180. The highest number of deaths occurred with SOFA scores between 11 to15 which was 16 deaths (51.6%). The highest number of deaths occurred with the qSOFA score 2 which were 24 deaths (77.4). Higher SOFA and qSOFA scores did not always correlate with increased mortality, probably because of other factors like associated comorbidities. Conclusion: This study confirmed the usefulness of SOFA and qSOFA scores to predict mortality and for screening of patients with sepsis. Nevertheless, mortality prediction needs assessment of many other factors such as concomitant comorbidities, infecting organism, site of sepsis, etc, along with SOFA and qSOFA scores. Hence, we should assess the SOFA and qSOFA scores of patients in sepsis and with it also assess the role of clinical history and examination and comorbidities along with other factors, for a complete understanding of the patient.