Comparison of QSOFA and sirs scores for the prediction of adverse outcomes of secondary peritonitis among patients admitted on the adult surgical ward in a tertiary teaching hospital in Uganda: a prospective cohort study

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dc.contributor.authorNkonge, Emmanuel
dc.contributor.authorKituuka, Olivia
dc.contributor.authorOcen, William
dc.contributor.authorAriaka, Herbert
dc.contributor.authorOgwal, Alfred
dc.contributor.authorSsekitoleko, Badru
dc.date.accessioned2022-05-02T22:38:02Z
dc.date.available2022-05-02T22:38:02Z
dc.date.issued2021
dc.description.abstractSIRS and qSOFA are two ancillary scoring tools that have been used globally, inside and outside of ICU to predict adverse outcomes of infections such as secondary peritonitis. A tertiary teaching hospital in Uganda uses SIRS outside the ICU to identify patients with secondary peritonitis, who are at risk of adverse outcomes. However, there are associated delays in decision making given SIRS partial reliance on laboratory parameters which are often not quickly available in a resource limited emergency setting. In response to the practical limitations of SIRS, the sepsis-3 task force recommends qSOFA as a better tool. However, its performance in patients with secondary peritonitis in comparison to that of SIRS has not been evaluated in a resource limited setting of a tertiary teaching hospital in a low and middle income country like Uganda. Objective: To compare the performance of qSOFA and SIRS scores in predicting adverse outcomes of secondary peritonitis among patients on the adult surgical wards in a tertiary teaching hospital in Uganda. Methods: This was a prospective cohort study of patients with clinically confirmed secondary peritonitis, from March 2018 to January 2019 at the Accident and Emergency unit and the adult surgical wards of a tertiary teaching hospital in Uganda. QSOFA and SIRS scores were generated for each patient, with a score of ≥2 recorded as high risk, while a score of < 2 recorded as low risk for the adverse outcome respectively. After surgery, patients were followed up until discharge or death. In-hospital mortality and prolonged hospital stay were the primary and secondary adverse outcomes, respectively. Sensitivity, specificity, PPV, NPV and accuracy at 95% confidence interval were calculated for each of the scores using STATA v.13. Results: A total of 153 patients were enrolled. Of these, 151(M: F, 2.4:1) completed follow up and were analysed, 2 were excluded. Mortality rate was 11.9%. Fourty (26.5%) patients had a prolonged hospital stay. QSOFA predicted in-hospital mortality with AUROC of 0.52 versus 0.62, for SIRS. Similarly, qSOFA predicted prolonged hospital stay with AUROC of 0.54 versus 0.57, for SIRS. Conclusion: SIRS is superior to qSOFA in predicting both mortality and prolonged hospital stay among patients with secondary peritonitis. However, overall, both scores showed a poor discrimination for both adverse outcomes and therefore not ideal tools.en_US
dc.identifier.citationNkonge, E., Kituuka, O., Ocen, W., Ariaka, H., Ogwal, A., & Ssekitoleko, B. (2021). Comparison of QSOFA and sirs scores for the prediction of adverse outcomes of secondary peritonitis among patients admitted on the adult surgical ward in a tertiary teaching hospital in Uganda: a prospective cohort study. BMC Emergency Medicine, 21(1), 1-8. https://doi.org/10.1186/s12873-021-00528-xen_US
dc.identifier.urihttps://doi.org/10.1186/s12873-021-00528-x
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3176
dc.language.isoenen_US
dc.publisherBMC Emergency Medicineen_US
dc.subjectSecondary peritonitisen_US
dc.subjectAdverse outcomesen_US
dc.subjectqSOFAen_US
dc.subjectSIRSen_US
dc.titleComparison of QSOFA and sirs scores for the prediction of adverse outcomes of secondary peritonitis among patients admitted on the adult surgical ward in a tertiary teaching hospital in Uganda: a prospective cohort studyen_US
dc.typeArticleen_US
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