Effectiveness of qSOFA and NEWS in predicting mortality in sepsis patients presenting in emergency department: A prospective study

Objective: Early sepsis can be treated if recognised early, but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality. The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment (qSOFA) score with National Early Warning Score (NEWS) in prognosticating sepsis. Methods: This prospective observational study was conducted among patients >18 years old presenting with sepsis at B.J. Medical College. The SOFA, qSOFA and NEWS scores were calculated. The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis. Results: A total of 200 patients were evaluated (56% male) with a mean age of 51.7 years. The mortality rate was 23%. Patients categorized under high risk according to SOFA score >8, qSOFA score of 2-3 and NEWS >7 had a mortality rate of 33.3%, 27.5% and 28.4%, respectively. AUC for mortality prediction was 0.695 using SOFA score, 0.665 using qSOFA and 0.725 using NEWS. At a cut off of 7.50, NEWS demonstrated a sensitivity of 97.8% with a specificity of 28.0% and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5% and 91.3% and a specificity of 77.9% and 27.9%, respectively. Conclusions: The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients. However, qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.