Prognostic value of qSOFA score in liver cirrhosis patients combined with sepsis

Abstract

Abstract: Objective To investigate the prognostic value of quick sequential organ failure assesment (qSOFA) score in decompensated liver cirrhosis (DLC) patients combined with sepsis, and to provide clinical theoretical basis in early rapid assessment. Methods Sixty-five DLC patients combined with sepsis from May 2017 to May 2021 were included (41 males and 24 females). They were divided into death group and survival group according to the different treatment outcomes. Taking death as an indicator of adverse prognosis, receiver operating characteristic curve was used to analyze the clinical value of qSOFA score, modified early warning score (MEWS) and Child-Pugh score in evaluating the prognosis of patients. Results There were 39 cases and 26 cases in the survival and death groups, respectively. The serum levels of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT) and platelet (PLT) in the survival group were (11.8±2.9)×10⁹/L, (32.0±12.9) mg/L, (2.9±0.3) ng/mL and (112.9±37.0)×10⁹/L, respectively. The serum levels of WBC, CRP, PCT and PLT in the death group were (14.3±1.8)×10⁹/L, (67.7±28.4) mg/L, (5.7±2.2) ng/mL and (63.5±23.7)×10⁹/L, respectively. The differences between the 2 groups were statistically significant (P<0.05). The prothrombin time (PT) and international normalized ratio (INR) in survival group were (18.3±6.3) s and (1.2±0.2), which were significantly different from those in death group [(22.8±9.7) s and (2.5±1.0)] (P<0.05). The alanine transaminase (ALT), blood ammonia and total bilirubin (TBiL) in the survival group were (163.8±35.7) U/L, (36.3±12.7) μmol/L and (58.2±18.1) μmol/L, which were significantly higher than those in the death group [(498.2±163.5) U/L, (82.4±8.2) μmol/L and (231.5±75.4) μmol/L] (P<0.05). The qSOFA score, Child-Pugh score and MEWS in the survival group were (1.1±0.4), (6.1±2.1) and (6.3±2.6), which were significantly higher than those in the death group [(2.3±0.5), (7.9±0.8) and (9.8±1.1)] (P<0.05). The area under the curve (AUC) of qSOFA score, MEWS and Child-Pugh score were 0.68, 0.73 and 0.67, respectively. Sensitivity were 89.7%, 97.4% and 84.6%, respectively. Specificity were 46.2%, 88.5% and 65.4%, respectively. Conclusion There is clinical significant of the qSOFA score in evaluating the prognosis of DLC patients combined with sepsis. The evaluation efficacy of qSOFA score is similar to MEWS and Child-Pugh score, but the specificity of qSOFA score is lower than that of MEWS and Child-Pugh score.

Key words: Quick sequential organ failure assessment score, Decompensated cirrhosis, Sepsis, Modified early warning score, Child-Pugh grading

WANG Qing, WENG Yan, CHEN Yi-wen, JIN Chang-ming, SUN Jing. Prognostic value of qSOFA score in liver cirrhosis patients combined with sepsis[J]. Chinese Hepatolgy, 2021, 26(12): 1348-1350.

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