Prognostic performance of qSOFA in pulmonary embolism

Aim: We aimed to investigate the role of the quick sequential organ failure assessment (qSOFA) score in determining the prognosis of patients with acute pulmonary embolism (PE).

Materials and Methods: Patients older than 18 years old who were admitted to the emergency department with complaints of shortness of breath and/or chest pain for 3 years and who were found to have acute PE on computed tomography pulmonary angiography were included in the study. The values of qSOFA, pulmonary embolism severity index (PESI), simplified PESI were calculated in patients with acute PE. During the follow-up, in-hospital mortality and the requirement of intensive care continuation was determined.

Results: 166 acute PE patients, 88 (53%) women, were included in the study. The mean age of the patients was 67.4±17.3. 26 patients (15.7%) were admitted to the intensive care unit (ICU). Mortality rate was 9% (n=15). The predictive value of qSOFA in determining in-hospital mortality (AUC: 0.907, 95% CI: 0.852-0.946) was similar to PESI (AUC: 0.846, %95 CI: 0.782-0.897) and sPESI (AUC: 0.796, 95% CI: 0.726-0.854) (p=0.23 and p=0.16 respectively). While it was superior to PESI (AUC: 0.794, 95% CI: 0.724-0.852) and sPESI (AUC: 0.721, 95% CI: 0.646-0.787) in determining the inclusion of patients in ICU (AUC: 0.882, 95% CI: 0.823-0.927) (p=0.04 and p=0.01 respectively). There was a positive correlation between qSOFA and PESI (r=0.49, p=0.001) and sPESI (r=036, p=0.001).

Conclusions: As a result of this study, we found that the qSOFA score performed well in determining in-hospital mortality and ICU admission in acute PE patients admitted to the emergency department.