Quick Sequential Organ Failure Assessment to identify clinical deterioration in adults with COVID-19: a retrospective cohort.
Luiz Felipe Sales Mauricio, Cassia Regina Vancini Campanharo, Luiz Humberto Vieri Piacezzi and 2 others
PMID 40396841WHAT IT FOUND
A positive qSOFA on admission was associated with clinical deterioration, but qSOFA missed many deteriorations in adults with COVID-19 in the emergency department.
Use it to complement, not replace, clinical assessment.
Key findings
01A positive qSOFA on admission was associated with clinical deterioration, but qSOFA had higher specificity and low sensitivity for tracking deterioration.
02The area under the ROC curve was 0.68 on admission and 0.70 immediately before the event.
03At a cutoff of ≥ 1, qSOFA had 66% sensitivity and 55% specificity on admission, and 48% sensitivity and 88% specificity immediately before deterioration.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in a single private emergency department in Brazil, so it may not apply to other hospitals or patients. qSOFA had low sensitivity, so it cannot be used to rule out deterioration. The study was retrospective and used data recorded in electronic medical records.
The easy way to misread this
Do not use qSOFA alone to rule out clinical deterioration. It had low sensitivity, so a negative score does not exclude deterioration, and the authors state it should not be used alone.