Date of Award

5-2019

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Reena Shah

Second Supervisor/Advisor

Vitalis Mung’ayi

Third Supervisor/Advisor

Wangari Waweru-Siika

Department

Internal Medicine (East Africa)

Abstract

Background: Sepsis is global health priority and the commonest cause of death in critical care. SEPSIS 3 criteria introduced in 2016 is the latest tool in diagnosing sepsis, uses qSOFA and SOFA scores in place of the SIRS based definition for better prediction of mortality in patients with suspected infections. Their performance in predicting mortality in critical care units outside high- income countries remains largely unknown.

Objective: We compared the SOFA and qSOFA scores in predicting the hospital mortality of adult critical care patients admitted with suspected infection at the Aga Khan University Hospital Nairobi, Kenya.

Methods: We did a retrospective review of all admissions to the critical care units from January 2017 to December 2017, enrolling eligible patients. We censored on hospital discharge or death. We electronically collected clinical, demographic and outcome data. AUROC with 95 per cent confidence intervals for SOFA and qSOFA compares the scores.

Results: There were a total of 450 patients with a mean age of 56 years and 57.60% were male. There were 92 deaths (20.44%) and 284 (63.1%) patients experienced a prolonged ICU stay (≥3 days). Majority (371, 82.44%) manifested a SOFA score of two or more and 190 patients (42.22%) had a qSOFA score of two or more. SOFA score had a better ability in predicting in hospital mortality compared to qSOFA (AUROC of 0.799 (95% CI, 0.752 - 0.846) Vs AUROC of 0.694 (95% CI, 0.691 -0.748), P < 0.001).

Conclusion and recommendations: Among adult critical care patients with suspected infection at admission to critical care, a SOFA score of two or more was better than qSOFA score of two or more in predicting in-hospital mortality.

Download

Share

COinS