Analysis of the SOFA score, quick-SOFA, and SIRS criteria in burn patients with infection.
Francielli Mary Pereira Gimenez, Lucienne Tibery Queiroz Cardoso, Gilselena Kerbauy and 2 others
PMID 40802437WHAT IT FOUND
In burn ICU patients, SIRS, qSOFA and SOFA did not reliably identify infection.
Age, burn size and admission SOFA were associated with higher death risk. Do not use these scores alone to rule out infection.
Key findings
01SOFA, lactate and C-reactive protein were poor predictors of infection or death in burned ICU patients.
02At burn injury, before infection was detected, SIRS was positive in 153 patients and ∆SOFA was positive in 187 patients.
03Age, total body surface area burned and SOFA score at admission were associated with higher in-hospital mortality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single centre, so the results may not apply to other burn units. Retrospective medical records; 6 patients were excluded for incomplete data and 14 under 18 years were excluded, so children and patients with missing records are not represented. Infection was diagnosed by the attending physician using local hospital criteria, not by a masked reference standard. The authors noted the sample size may have hindered detection of minor differences.
The easy way to misread this
Do not conclude that a negative SOFA variation rules out serious infection in burned patients. The study was a retrospective record study, not a trial of treatment, and the scores had low accuracy for infection or death, although admission SOFA was still associated with mortality.