COMPARATIVE STUDY OF SEQUENTIAL ORGAN FAILURE ASSESSMENT, QUICK SEQUENTIAL ORGAN FAILURE ASSESSMENT, AND SYSTEMIC INFLAMMATORY RESPONSE SYNDROME CRITERIA IN EARLY SEPSIS DETECTION AMONG INTENSIVE CARE UNIT PATIENTS

Abstract

Background: Sepsis is a life-threatening condition associated with high morbidity and mortality among critically ill patients. Early recognition is essential to prevent progression to multi-organ failure. The Sequential Organ Failure Assessment (SOFA), Quick Sequential Organ Failure Assessment (qSOFA), and Systemic Inflammatory Response Syndrome (SIRS) criteria are widely used tools for early detection; however, their comparative diagnostic performance in ICU settings remains controversial.

Objective: To compare the diagnostic accuracy of SOFA, qSOFA, and SIRS criteria in early detection of sepsis among ICU patients.

Methodology: This hospital-based comparative cross-sectional study included 150 adult ICU patients with suspected or confirmed infection. Clinical and laboratory parameters were collected within the first 24 hours of admission to calculate SOFA, qSOFA, and SIRS scores. Diagnostic performance was evaluated using sensitivity, specificity, odds ratios, and receiver operating characteristic (ROC) curve analysis. Statistical analysis was performed using SPSS version 27.

Results: Among the participants, 70.7% were diagnosed with sepsis. SOFA demonstrated the highest sensitivity (86.8%) with good specificity (75.0%) and showed the strongest association with sepsis (OR = 19.714; 95% CI: 8.143–47.728; p < 0.001). qSOFA exhibited perfect specificity (100%) and positive predictive value (100%) but lower sensitivity (60.4%). SIRS showed moderate sensitivity (70.8%) and lower specificity (50.0%). ROC analysis revealed an area under the curve (AUC) of 1.000 for qSOFA, 0.854 for SIRS, and 0.830 for SOFA, indicating strong discriminative ability among the scoring systems.

Conclusion: SOFA demonstrated the most balanced diagnostic performance for early sepsis detection in ICU patients. While qSOFA is highly specific and effective for identifying high-risk cases, its lower sensitivity limits its standalone use. SIRS showed comparatively lower diagnostic precision. Organ dysfunction-based assessment using SOFA is recommended for timely and accurate identification of sepsis in critically ill populations