The Use of qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS) to Predict Severe Complications in Hematologic Malignancy Patients

Abstract

Background: Sepsis causes high mortality in vulnerable groups such as hematologic malignancy (HM) patients. There are various early warning scores of sepsis, eg, qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS). This study aimed to compare REWS, qSOFA, and SOFA in predicting severe complications in hematologic malignancy patients visiting ED. Methods: The study was conducted as a retrospective cohort study at the ED of Ramathibodi Hospital, Bangkok, Thailand. Adult HM patients suspected of sepsis and have visited ED between March 2016 and December 2019. Results: Among 124 patients in our cohort, 51 (41%) had serious complication in ED and 20 (16%) died within 28 days after admission. The AUROCs of SOFA and qSOFA indicate significantly higher predicting in serious complication in ED than REWS (SOFA, 0.81 [95% CI, 0.73–0.89], qSOFA, 0.73 [95% CI, 0.65–0.81], REWS, 0.62 [95% CI, 0.52–0.72] p=0.004) while the predicting in 28-day mortality is not statistically significantly different (SOFA, 0.73 [95% CI, 0.60–0.85], qSOFA, 0.69 [95% CI, 0.58–0.80], REWS, 0.60 [95% CI, 0.44–0.75] p=0.25). Conclusion: The SOFA score is highest in predicting severe complications among hematologic malignancy patients.