Prehospital and in-hospital quick Sequential Organ Failure Assessment (qSOFA) scores to predict in-hospital mortality among trauma patients: an analysis of nationwide registry data.

The quick Sequential Organ Failure Assessment (qSOFA) score can be used to predict in-hospital mortality in trauma patients. We sought to determine whether repeatedly calculating the qSOFA score improves its discriminative ability in predicting in-hospital mortality in trauma patients. We undertook a multicenter retrospective study, analyzing 90,974 trauma patients registered in the Japan Trauma Data Bank (a nationwide trauma registry) from 2004 to 2017. Patients included were ≥18 years old and transferred directly to hospitals from their respective scenes of injury. We calculated the qSOFA score at two time points: at the scene (prehospital qSOFA score) and on arrival at the hospital (hospital qSOFA score). We evaluated the discriminative ability of repeated calculations of the qSOFA score. The primary outcome in consideration was in-hospital mortality. In-hospital mortality occurred in 5604 patients (6.2%). The predictive accuracy of the hospital qSOFA score was higher than that of the prehospital qSOFA (area under the receiver operating characteristics curve [AUROC] 0.74 vs. 0.69, Repeated calculations of qSOFA score improved its ability to predict in-hospital mortality in trauma patients. Specifically, we should consider an increasing qSOFA score as a "red flag" to clinicians in the emergency department.

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© 2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.

Déclaration de conflit d'intérêts

Approval of the research protocol: The protocol for this research project was approved by a suitably constituted Ethics Committee of the institution and it conforms to the provisions of the Declaration of Helsinki. Committee of Wakayama Medical University, approval number 2632. Informed consent: Informed consent was waived because of the retrospective nature of the study. Registry and registration no. of the trial: UMIN‐CTR, UMIN000037249 (registered 3 July 2019, https://upload.umin.ac.jp/cgi‐open‐bin/ctr/ctr_view.cgi?recptno=R000042402). Animal studies: N/A. Conflict of interest: Dr. Miyamoto reports the receipt of lecture fees from Becton Dickinson, Maruishi Pharmaceutical, and Radiometer.