Comparison of the quick Sepsisrelated Organ Failure Assessment and adult sepsis pathway in predicting adverse outcomes among adult patients in general wards: a retrospective observational cohort study, Internal Medicine Journal

Background: Quick Sepsis ‐related Organ Failure Assessment (qSOFA) is recommended for use by the most recent international sepsis definition taskforce to identify suspected sepsis in patients outside the intensive care unit (ICU) at risk of adverse outcomes. Evidence of its comparative effectiveness with existing sepsis r ecognition tools is important to guide decisions about its widespread implementation. Aim: To compare the performance of qSOFA with the adult sepsis pathway (ASP), a current sepsis recognition tool widely used in NSW hospitals and systemic inflammatory response syndrome criteria in predicting advers e outcomes in adult patients on general wards. Methods: A retrospective observational cohort study was conducted which included all adults with suspected infections admitted to a Sydney teaching hospital between December 2014 and June 2016. The primary outcome was in‐hospital mortality with two se condary composite outcomes. Results: Among 2940 patients with suspected infection, 217 (7.38%) died in‐hospital and 702 (23.88%) were subsequently admitted to ICU. The ASP showed the greatest ability to correctly discriminate in‐hospital mortality and secondary outcomes. The area under the recei ver‐operating characteristic curve for mortality was 0.76 (95% confidence interval (CI): 0.74–0.78), compared to 0.64 for the qSOFA tool (95% CI: 0.61–0.67, P
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