The Use of qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS) to Predict Severe Complications in Hematologic Malignancy Patients

Abstract

Background

Sepsis causes high mortality in vulnerable groups such as hematologic malignancy (HM) patients. There are various early warning scores of sepsis, eg, qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS). This study aimed to compare REWS, qSOFA, and SOFA in predicting severe complications in hematologic malignancy patients visiting ED.

Methods

The study was conducted as a retrospective cohort study at the ED of Ramathibodi Hospital, Bangkok, Thailand. Adult HM patients suspected of sepsis and have visited ED between March 2016 and December 2019.

Results

Among 124 patients in our cohort, 51 (41%) had serious complication in ED and 20 (16%) died within 28 days after admission. The AUROCs of SOFA and qSOFA indicate significantly higher predicting in serious complication in ED than REWS (SOFA, 0.81 [95% CI, 0.73–0.89], qSOFA, 0.73 [95% CI, 0.65–0.81], REWS, 0.62 [95% CI, 0.52–0.72] p=0.004) while the predicting in 28-day mortality is not statistically significantly different (SOFA, 0.73 [95% CI, 0.60–0.85], qSOFA, 0.69 [95% CI, 0.58–0.80], REWS, 0.60 [95% CI, 0.44–0.75] p=0.25).

Conclusion

The SOFA score is highest in predicting severe complications among hematologic malignancy patients.

Keywords:

• sepsis
• qSOFA
• SOFA
• early warning score
• hematologic malignancy

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

This study was not funded.