Prehospital quick sequential organ failure assessment score for predicting in-hospital mortality among patients with trauma: an analysis of nationwide registry data

Not Applicable

• Conditions: Trauma

• Registration Number: JPRN-UMIN000034928
• Lead Sponsor: Wakayama Medical University

Brief Summary

Objective The quick sequential organ failure assessment (qSOFA) score is calculated from three variables measured at the scene of trauma: systolic blood pressure, respiratory rate and consciousness. This study aimed to evaluate the discriminative ability of the prehospital qSOFA score for in-hospital mortality in patients with trauma. Methods This retrospective multicenter study used data from 42,722 patients with trauma included in a Japanese nationwide trauma registry. All included patients were aged >=18years old and transferred to hospitals from the scenes of injury. The primary outcome was in-hospital mortality. Results The included patients had a mean age of 59.4+-21.5years and a male predominance (63%). In-hospital mortality occurred in 2612 patients (6%), while 2-day mortality occurred in 1189 of 42,339 patients (3%). When patients were stratified by qSOFA scores, in-hospital mortality rates of 0.9% (105/11783), 5% (941/17839), 12% (1280/11132) and 15% (286/1968) were associated with qSOFA scores of 0, 1, 2 and 3, respectively (P<0.0001 for trend). The area under the receiver operating characteristics curve of the qSOFA score for in-hospital mortality was 0.70 (95% confidence interval: 0.69-0.71). A qSOFA score cutoff value >=1 yielded a sensitivity and specificity of 0.96 and 0.29, respectively, overall, and a sensitivity of 0.99 in patients younger than 65years. Conclusions The prehospital qSOFA score was strongly associated with in-hospital mortality in patients with trauma. A prehospital qSOFA score cutoff of >=1 can be used to identify patients at a very low risk of death, especially in younger age groups.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2018-11-28
• Study Completion: 2018-11-28
• Last Update Posted: 20 November 2023

Recruitment & Eligibility

• Status: Complete: follow-up complete
• Sex: All
• Target Recruitment: 40000

Inclusion Criteria

Not provided

Exclusion Criteria

We excluded patients who had been transferred from other hospitals, presented with burn injuries, were <18 years old or exhibited cardiopulmonary arrest on the scene, as well as those with missing data for age, discharge outcome or vital signs at the scene, including the respiratory rate (RR), Japan Coma Scale (JCS) score or systolic blood pressure (SBP).

Study & Design

• Study Type: Observational
• Study Design: Not specified