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Title: Prognostic performance of qSOFA in oncology patients admitted to the emergency department with suspected infection.
Austin Authors: Koh, Tze Lui ;Canet, Emmanuel;Amjad, Sobia;Bellomo, Rinaldo ;Taylor, David McD ;Gan, Hui K ;Marhoon, Nada ;Lim, Andrew Boon Ming ;Ong, Wee Loon ;Krishnan, Vivek;Khor, Richard 
Affiliation: Intensive Care
School of Clinical Medicine, University of Cambridge, Cambridge, UK
La Trobe University School of Cancer Medicine, Heidelberg, Victoria, Australia
Medicine (University of Melbourne)
University of Melbourne, Parkville, Victoria, Australia
Medical ICU, Hôtel-Dieu, University Hospital, Nantes, Loire-Atlantique, France
Radiation Oncology
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Victoria, Australia
MKM Health, South Yarra, Victoria, Australia
Medical Oncology
Olivia Newton-John Cancer Wellness and Research Centre
Issue Date: 20-Feb-2021
Date: 2020-10-20
Publication information: Asia-Pacific Journal of Clinical Oncology 2021; 17(1): 94-100
Abstract: We aimed to test the performance of the quick Sequential Organ Failure Assessment score (qSOFA) in predicting the outcomes of oncology patients admitted to the emergency department (ED) with suspected infection. Retrospective cohort analysis of all oncology patients presenting to the ED of a tertiary hospital with suspected infection from 1 December 2014 to 1 June 2017. Patients were identified by cross-linkage of ED and Oncology electronic health records. The primary outcome was in-hospital mortality and/or ICU stay ≥ 3 days. A total of 1655 patients were included in this study--1267 (76.6%) with solid tumor and 388 (23.4%) with hematological malignancies. At presentation, 495 patients had chemotherapy, and 140 had radiotherapy within the preceding 6 months. Four hundred patients received chemotherapy and/or radiotherapy in the previous 4 weeks. Overall, 371 (22.4%) patients had qSOFA ≥ 2. Such patients had a higher likelihood of respiratory infections compared to patients with a qSOFA < 2 (43.9% vs 29%) and were more likely to be admitted to ICU or require mechanical ventilation. In-hospital mortality or in-hospital mortality and/or ICU stay ≥ 3 days were 17.3% and 21%, for qSOFA ≥ 2 patients versus 4.7% and 6.9% for qSOFA < 2 patients (P < .001). qSOFA ≥ 2 had a negative predictive value of 95% for in-hospital mortality and 93% for in-hospital mortality or ICU stay ≥ 3 days. Among oncology patients presenting to the ED with suspected infection, a qSOFA ≥ 2 is associated with a threefold risk of hospital mortality/prolonged ICU stay. Its absence helps identify low-risk patients.
DOI: 10.1111/ajco.13422
ORCID: 0000-0001-6828-6445
Journal: Asia-Pacific Journal of Clinical Oncology
PubMed URL: 33078888
Type: Journal Article
Subjects: cancer
septic shock
Appears in Collections:Journal articles

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