J. R. Merida1, Z. Naeem1, A. Mukhi1, H. Hsieh1, R. Jawa1 1Stony Brook University Medical Center, Stony Brook, NY, USA
Introduction: The quick Sequential Organ Failure (qSOFA) score has been used to identify non-ICU patients with suspected infection who are at an elevated risk of death. We determined its validity in determining adverse outcomes in adult blunt trauma patients.
Methods: We queried the trauma registry of an ACS verified Level 1 Adult Trauma Center for all adult blunt trauma admissions between 1/2019 and 9/2021. qSOFA scores are the sum of the binary scores for 3 variables (Respiratory Rate >= 22, Systolic Blood Pressure <= 100 mmHg, and Glasgow Coma Score <= 13).
Results: There were 3,730 total admissions (Table 1). Group size decreased as qSOFA score increased. Median age decreased from 72 (IQR: 53-83) to 50 years (IQR: 36-52) from qSOFA=0 to qSOFA=3, p<0.001. Higher qSOFA scores were associated with greater injury severity for all categories. The largest differences were seen in head and neck injuries, with over 55% of those with a qSOFA score of 3 having a severe head and neck injury (AIS>=3) as compared to 15.2% at a qSOFA of 0. The qSOFA score was associated with higher complication rates and higher in-hospital mortality rates. Shock Index was significantly greater with higher qSOFA scores. The Probability of Survival (TRISS) which integrates the injury severity score, was significantly lower with higher qSOFA scores.
Conclusion: Based on index vital signs and GCS at ED presentation, patients with higher qSOFA scores have higher injury severity, complication rates, and mortality rates in adults. Higher qSOFA scores were also associated with a lower probability of survival using the TRISS score which incorporates injury severity. The qSOFA can serve as a quick and easy scoring system to allocate resources and determine adverse outcomes, with a qSOFA>=2 being the recommended cutoff for adult patients.
