Comparison of q- SOFA score and omq-SOFA score for predicting prognosis in cases of obstetric sepsis- Experience in a tertiary care teaching institute in Uttar Pradesh, India

Background: Sepsis represents a significant public health concern, occurring when the body's response to an infection damages its own organs and tissues. Without early recognition and timely treatment, sepsis can progress rapidly to shock and potentially death. Physiological and immunological changes during pregnancy, labor and post-partum increase the susceptibility to infections as well as may mask signs of infection and sepsis, leading to delays in diagnosis and treatment. Material and Methods: This prospective observational study was conducted in the department of obstetrics and gynecology at Baba Raghav Das Medical College , Gorakhpur, Uttar Pradesh from 1/05/2023 to 30/04/2024. 164 patients admitted with diagnosis of obstetric sepsis and who met the inclusion criteria were included in the study. A semi-structured proforma with patient’s particulars, clinical profile and relevant investigations was used . q-SOFA and omq-SOFA scores were calculated on the day of admission and subsequently on multiple days for each patient. Results In our study, the most common microbial agent identified was Escherichia coli in 34(42.5%) participants followed by Group B Streptococcus in 18 (22.5%) participants and others. Assessment (q-SOFA) and obstetric-modified quick SOFA (omq-SOFA) with maternal mortality among the study participants (N = 164). For the q-SOFA score, 21.4% (n = 9/42) of participants with a score of 0 experienced maternal mortality, while this increased significantly to 70.0% (n = 21/30) for those with a score of 1, 73.0% (n = 54/74) for a score of 2, and 77.7% (n = 14/18) for a score of 3. Similarly, the omq-SOFA score showed that 21.4% (n = 10/46) of participants with a score of 0 experienced maternal mortality, which rose to 44.2% (n = 19/43) for a score of 1, 81.6% (n = 53/65) for a score of 2, and 100% (n = 10/10) for a score of 3. Conclusion: Our study concludes omq-SOFA score is better than q-SOFA score with superior predictive accuracy of both adverse maternal outcome and mortality in patients with obstetric sepsis and should be incorporated into clinical practice for early risk stratification and timely management leading to improved patient outcomes.