Evaluation value of qSOFA combined oxygenation index on severity and prognosis of critically ill patients

Zhen Yunyu; Wu Yaguang; Zhao Xianghui

doi:10.3969/j.issn.1674-3245.2025.01.006

Abstract：Objective To explore the utility of the quick Sequential Organ Failure Assessment(qSOFA)score combined with the oxygenation index(PaO2/FiO2)in assessing the severity and prognosis of critically ill patients with cardiovascular diseases in the emergency department.Methods A total of 168 critically ill patients with APACHEⅡ>20 in the emergency department of our hospital were selected from February 2021 to July 2022,including 95 males and 73 females.The average age was(63.30±17.23)years,ranging from 18 to 92 years.The predictive value,sensitivity and specificity of qSOFA and PaO2/FiO2 for critically ill patients and mortality in each group were calculated by receiver operating characteristic curve(ROC)according to APACHEⅡscore and prognosis.Results The area under the ROC curve for predicting high-risk patients using qSOFA was 0.774(95%CI=0.703～0.835),with a threshold of qSOFA≥2,sensitivity of 58.49%,and specificity of 88.70%,and the specificity was 88.70%.The area under ROC curve predicted by qSOFA combined with PaO2/FiO2 was 0.843(95%CI=0.7699～0.887),the sensitivity was 77.36%,and the specificity was 86.89%in high-risk patients.In addition,qSOFA predicted an area under the ROC curve of 0.817(95%CI=0.750～0.872),a sensitivity of 70.27%,and a specificity of 86.26%.The area under ROC curve of qSOFA combined with PaO2/FiO2 for predicting death was 0.861(95%CI=0.799～0.909),corresponding to 89.19%sensitivity and 85.50%specificity.Conclusion qSOFA combined with PaO2/FiO2 has higher accuracy in evaluating the severity and prognosis of emergency patients,which is better than the prediction ability of qSOFA alone,and has certain value for emergency identification of critically ill patients.