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Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score
Min Woo Kang, Seo Young Ko, Sung Wook Song, Woo Jeong Kim, Young Joon Kang, Kyeong Won Kang, Hyun Soo Park, Chang Bae Park, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee
J Trauma Inj. 2021;34(1):3-12.   Published online December 17, 2020
DOI: https://doi.org/10.20408/jti.2020.0048
  • 5,670 View
  • 174 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools.

Methods

This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients’ initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC).

Results

In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63–56.79) for a qSOFA score of 1, 373.31 (183.47–759.57) for a qSOFA score of 2, and 494.07 (143.75–1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871–0.952]) was significantly greater than those for the ISS (0.700 [0.608–0.793]) and RTS (0.160 [0.108–0.211]).

Conclusions

The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

Summary

Citations

Citations to this article as recorded by  
  • Clinical utility of the quick Sequential Organ Failure Assessment score in predicting life-threatening traumatic hemorrhage: An observational study
    Susumu Matsushime, Akira Kuriyama
    The American Journal of Surgery.2024; 229: 140.     CrossRef
  • Multifaceted Analysis of the Environmental Factors in Severely Injured Trauma: A 30-Day Survival Analysis
    Sung Woo Jang, Hae Rim Kim, Pil Young Jung, Jae Sik Chung
    Healthcare.2023; 11(9): 1333.     CrossRef
  • Predictive value of quick sequential organ failure assessment (qSOFA) score in risk assessment and outcome prediction in blunt trauma patients: A prospective observational study
    Nidhisha Sadhwani, Vinaya Ambore, Girish Bakhshi
    Annals of Medicine & Surgery.2022;[Epub]     CrossRef
Physician-staffed Helicopter Transport for Mountain-rescued Emergency Patients: a Pilot Trial
Jeong Ho Park, Sang Do Shin, Eui Jung Lee, Chang Bae Park, Yu Jin Lee, Kyoung Soo Kim, Myoung Hee Park, Han Bum Kim, Do Kyun Kim, Woon Yong Kwon, Young Ho Kwak, Gil Joon Suh
J Trauma Inj. 2012;25(4):230-240.
  • 1,440 View
  • 18 Download
AbstractAbstract PDF
PURPOSE
We aimed to compare the transport time, the proportion of direct hospital visit and the emergency procedures between the current mountain rescue helicopter emergency medical service (HEMS) and physician-staffed mountain-rescue HEMS.
METHODS
During weekends from October 2, to November 21, 2010, 9 emergency physicians participated as HEMS staff in the mountain-rescue HEMS program of the Seoul fire department. Patient demographic data, transport time, proportion of direct hospital visits, and emergency procedures were recorded. We also collected data on HEMS mountain-rescued patients from June 1, to September 1, 2010, and we compared them to those for the study patients. After an eight-week trial of the HEMS, we performed a delphi survey to determine the attitude of the physician staff, as well as the feasibility of using a physician staff.
RESULTS
Twenty-four(24) patients were rescued from mountains by physician-staffed HEMS during the study period, and 35 patients were rescued during the pre-study period. Patient demographic findings were not statistically different between the two groups, but the transport time and the emergency procedures were. During the study period, the time from call to take-off was 6.1+/-4.1 min (vs. 12.1+/-8.9 min during the pre-study period, p-value=0.001), and the time from call to arrival at the scene was 15.0+/-4.8 min (vs. 22.3+/-8.1 min during the pre-study period, p-value=0.0001). The proportions of direct hospital visit were not different between the two groups, but more aggressive emergency procedures were implemented in the study group. The delphi survey showed positive agreement on indications for HEMS, rapidity of transport and overall satisfaction.
CONCLUSION
A pilot trial of physician-staffed HEMS for mountain rescue showed rapid response and more aggressive performance of emergency procedures with high satisfaction among the attending physicians.
Summary

J Trauma Inj : Journal of Trauma and Injury
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