Comparison of prognosis prediction values of SIRS, qSOFA, SOFA, IWGDF scoring in patients with diabetic foot- connected sepsis, severe sepsis and septic shock diagnosis

Aim: We aimed to find out which classification has better predictive power by determining the amputation risk and clinical outcome predictive values of SIRS, qSOFA, SOFA and IWGDF scores in patients diagnosed with sepsis, severe sepsis and septic shock due to diabetic foot infection. Materials and Methods: The present study is a retrospective study that included a total of 207 patients who were over the age of 18 and hospitalized in the wound care unit due to diabetic foot infection between January 2017 and December 2019. The patients' SIRS, qSOFA, SOFA and IWGDF scores were calculated from their files. Their demographic information, previous history, vital signs, physical examination findings, laboratory information, treatment strategy, treatment process and clinical outcomes were recorded and subjected to an evaluation. Results: A total of 207 patients, 157 (75.85%) male, 50 (24.15%) female, were included in our study. We found qSOFA, IWGDF and SOFA scores to be statistically significant in predicting the clinical outcome and qSOFA and SIRS scores in predicting the risk of amputation. It was determined that qSOFA scores were the most optimal compared with other scoring systems. ROC (Receiver operating characteristic Curve) analysis revealed that the predictive value of qSOFA score was one (sensitivity 87.50%, specificity 90.45%) in predicting the clinical outcome and zero (sensitivity 58.77%, specificity 69.89%) in predicting the amputation status. Conclusion: We have noticed that the specificity and sensitivity values of scoring systems in predicting mortality and amputation risk are different from each other. The results of our study have led us to conclude that the qSOFA score can be used in determining the clinical outcome and will contribute to the literature. We think that multi center studies are necessary to obtain clearer information.