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Comparison of the Quick Sepsis-related Organ Dysfunction score and severity levels assigned with the Andorran Triage Model in an urban tertiary care hospital emergency department

Monclús Cols E, Ugarte Ramos A, Gabara Xanco C, Ladino Vasquez A, Padrosa Pulido J, Ortega Romero M

Área de Urgencias, Hospital Clínic, Barcelona, Spain. Servicio de Medicina Interna, Hospital Clínic, Barcelona, Spain. Universidad de Barcelona. Barcelona, Spain.

Objective. To compare the usefulness of the Quick Sepsis-related Organ Dysfunction (qSOFA) score and the Andorran Triage Model in a hospital emergency department.
Methods. Patients who came to emergency department of a tertiary-eme hospital during the first hour of the morning shift over a 6-month period were included in the study if severity was assessed as level 2 or 3 according to the Andorran model. The qSOFA score was also assessed on arrival. The patients were then followed prospectively in the department and if they were admitted, follow-up continued on the ward. Thirty-day mortality was analyzed with Kaplan-Meier curves and the Cox multiple-variable regression model.
Results. A total of 322 patients with a mean age of 61 years were included. The qSOFA scores on arrival in the department were 0–1 points in 294 patients (91%) and 2–3 points in 28 (9%). Fourteen patients died as a consequence of the emergency. The 30-day probability of survival was calculated to be 97%. Factors related to mortality were level-2
triage classification, a qSOFA score of 2–3 points, age 70 years or older, and an abbreviated Charlson index of 4 points or higher. A qSOFA score of 2–3 points was the only independent variable associated with mortality in the Cox model.
Conclusion. The qSOFA score is a useful triage indicator in patients who come to a hospital emergency department. It identifies patients with a worse prognosis.

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