Predictive value of QSOFA in early mortalityrisk assessment of acute pulmonary embolism

Aims: In our study, it is aimed to quickly determine the mortality risk classification by using qSOFA, which contains three parameters instead of PESI and sPESI, in early mortality risk classification in acute PTE patients, without relying on laboratory data at the first moment we see the patient. For this reason, qSOFA score was used to quickly predict organ dysfunction in patients with sepsis. Materials and Methods: Our study was conducted between January 2019 and May 2020 in Karadeniz Technical University Faculty of Medicine Hospital Pulmonology Clinic. Patients who were diagnosed with acute PTE in the pulmonology service, outpatient clinic, intensive care unit and the emergency department of our hospital and followed up in the outpatient and inpatients were included in the study. PESI, sPESI and qSOFA scores were calculated to determine the acute PTE early mortality risk classification of the patients. ROC analysis was used to compare the accuracy of the qSOFA score level in predicting mortality risk classification in acute PTE. The area under the ROC curve (AUC) for the qSOFA score variable was calculated with 95% confidence intervals. Statistically p <0.05 was considered significant. Results: During the study, 123 patients who were objectively diagnosed with Pulmonary Thromboembolism (PTE) and followed up were prospectively observed. 46 of the patients were male, 77 of them were female, and the median age was 72 (19-102). According to qSOFA value, patients; 51 (41.5%) 0 (zero) point, 46 (37.4) 1 (one) point, 17 (13.8%) 2 (two) points, 9 (7.3%) scored 3 (three) points; 97 (78.9%) of them were in the low risk group (qSOFA <2), 26 (21.1%) were in the high risk group (qSOFA ≥2). When the qSOFA score of the patients was compared with the early mortality risk classification in acute PTE, it was observed that patients with high qSOFA score were in the high-risk group in the early mortality risk classification in acute PTE (p <0.001). Early mortality risk dual classification (low-high) in acute PTE patients compared with qSOFA score value; the qSOFA score was found to be high in the group with high mortality risk classification in acute PTE (sensitivity 100%, specificity 54.26%, AUC: 0.884, 95% confidence interval 0.814-0.935) (p value <0.001) high risk of qSOFA (≥2) It was shown that 69.2% of 26 patients were in the high risk group in the early mortality risk dual classification in acute PTE (p <0.0001). Conclusion: Our study concluded that the qSOFA scoring system can be useful in early mortality risk classification in patients with acute PTE. The qSOFA score guides in identifying patients with acute PTE with potentially life-threatening haemodynamic decompensation or collapse who need reperfusion therapy. As soon as a high qSOFA (≥2) value is detected, the patient should be closely monitored, and preliminary should be made for reperfusion therapy. More studies are needed on this subject.