CC BY 4.0 · Surg J (N Y) 2021; 07(03): e199-e202
DOI: 10.1055/s-0041-1733831
Original Article

QSIRS Can Improve Accuracy of QSOFA and SIRS in Prediction of Mortality in Surgical Emergencies

1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Adja Coumba Diallo
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Jacques Noel Tendeng
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Amadou Ibra Diallo
2   Department of Public Health and Preventive Medicine, Cheikh Anta Diop University, Dakar, Senegal
,
Mohamed Lamine Diao
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Sylvain Assega Sagna
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Saer Diop
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Diago Anta Dia
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Daouda Diouf
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Bayo Ismael Racine
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Philippe Manyacka Ma Nyemb
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
,
Ibrahima Konaté
1   Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
› Author Affiliations
Funding None.

Abstract

Background The quick sequential organ failure assessment (QSOFA) score and the systemic inflammatory response syndrome (SIRS) criteria were developed to predict the risk of sepsis and death in patients received in emergency. To improve sensitivity in predicting death, the association of the two scores was proposed under the term QSIRS (QSOFA + SIRS). Our aim was to determine the accuracy of QSOFA, SIRS, and QSIRS in prediction of mortality in surgical emergencies, and to compare these scores.

Patients and Methods This is a prospective study over a period of 1 year. Patients older than 15 years who presented a digestive surgical emergency (bowel obstruction, peritonitis, appendicitis, strangulated hernia) were included. For each score, the specificity, the sensitivity, the positive predictive value, the negative predictive value, and areas under the receiver operating characteristic (ROC) curve (AUC) were compared.

Results One hundred and eighteen patients were included and 11 deaths were recorded (9.3%). There was a statistically significant relationship between each score and death (QSOFA p = 0.01, SIRS p = 0.003, and QSIRS p = 0.004). The realization of the ROC curve found a higher AUC for QSIRS (0.845 [0.767–0.905]) compared with QSOFA (0.783 [0.698–0.854]) and SIRS (0.737 [0.648–0.813]). QSIRS (90.9%) had a higher sensitivity compared with the two other scores alone (SIRS = 81.9% and QSOFA = 36.3%).

Conclusion Our study found that QSIRS improves the ability to predict death in digestive surgical emergencies.



Publication History

Received: 18 June 2020

Accepted: 08 April 2021

Article published online:
03 August 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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