Mortality outcomes based on ED qSOFA score and HIV status in a developing low income country - 15/10/18
Abstract |
Objective |
To evaluate the utility of the quick Sepsis-related Organ Failure Assessment (qSOFA) score to predict risks for emergency department (ED) and hospital mortality among patients in a sub-Saharan Africa (SSA) setting.
Methods |
This retrospective cohort study was carried out at a tertiary-care hospital, in Kigali, Rwanda and included patients ≥15years, presenting for ED care during 2013 with an infectious disease (ID). ED and overall hospital mortality were evaluated using multivariable regression, with qSOFA scores as the primary predictor (reference: qSOFA=0), to yield adjusted relative risks (aRR) with 95% confidence intervals (CI). Analyses were performed for the overall population and stratified by HIV status.
Results |
Among 15,748 cases, 760 met inclusion (HIV infected 197). The most common diagnoses were malaria and intra-abdominal infections. Prevalence of ED and hospital mortality were 12.5% and 25.4% respectively. In the overall population, ED mortality aRR was 4.8 (95% CI 1.9–12.0) for qSOFA scores equal to 1 and 7.8 (95% CI 3.1–19.7) for qSOFA scores ≥2. The aRR for hospital mortality in the overall cohort was 2.6 (95% 1.6–4.1) for qSOFA scores equal to 1 and 3.8 (95% 2.4–6.0) for qSOFA scores ≥2. For HIV infected cases, although proportional mortality increased with greater qSOFA score, statistically significant risk differences were not identified.
Conclusion |
The qSOFA score provided risk stratification for both ED and hospital mortality outcomes in the setting studied, indicating utility in sepsis care in SSA, however, further prospective study in high-burden HIV populations is needed.
Le texte complet de cet article est disponible en PDF.Abbreviations : aRR, AUC, CV, CNS, CKD, CI, DM, ED, GU, GCS, HICs, IVF, ICU, IRR, IQR, LMICs, mmHg, qSOFA, RR, SSA, SBP, TB, UTH-K
Keywords : Sepsis, qSOFA, HIV, Mortality, Emergency care, Rwanda, Africa
Plan
☆ | Prior presentations: Preliminary results from this work were presented at the Society for Academic Emergency Medicine meeting, Indianapolis, USA. 15–18 May 2018. |
Vol 36 - N° 11
P. 2010-2019 - novembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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