Alfarizi, Aditya
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Comparison of NEWS, SIRS, and qSOFA Score as Predictors of Mortality and Length of Stay in Patients Pneumonia with Sepsis Harsini, Harsini; Alfarizi, Aditya; Aphridasari, Jatu; Raharjo, A Farih; Reviono, Reviono
Jurnal Respirologi Indonesia Vol 44 No 1 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i1.505

Abstract

Background: Pneumonia is a major health problem in all age groups and often related with sepsis. In 2021, Surviving Sepsis Campaign Guidelines mentioned several clinical scoring systems to identify patients with potentials of developing sepsis, such as systemic inflammatory response syndrome (SIRS), national early warning score (NEWS), quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA). The guideline stated that there is no gold standard for diagnosing sepsis, contradicting The Sepsis-3 Guideline in 2016 that mentioned SOFA score as a gold standard for diagnosing sepsis.Methods: Subjects were all patients with pneumonia and sepsis who were treated in Dr.Moewardi Hospital within 1 January to 31 December 2022. Data from subjects’ medical records were collected to assess their NEWS, SIRS, qSOFA, and SOFA score on the day of admission. Since evaluation of SOFA score needs a number of components requiring laboratory results and takes longer time so they made a simpler tool called qSOFA to avoid delayed treatment of the patients.Results: NEWS is more consistent with SOFA compared to SIRS and qSOFA (Kappa value = 0.726 vs 0.320 vs 0.22; respectively). NEWS, SIRS, and qSOFA were all significantly correlated with mortality (P<0.001) with NEWS having the strongest correlation (r=0.482 vs 0.216 vs 0.175; respectively). Only NEWS showed significant correlation with the length of stay (r=0.129; P<0.001).Conclusion: NEWS was the most consistent score to SOFA compared to SIRS and qSOFA. NEWS was also the best predictor for mortality and was the only score correlated with length of hospital stay.
Does the SOFA Score Have the Ability to Predict Length of Stay and Mortality as well as Other Scorings? Adhiputri, Artrien; Hapsari, Brigitta Devi Anindita; Reviono, Reviono; Alfarizi, Aditya; Damayanti, Raninditya
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i1.637

Abstract

Background: In the intensive care unit (ICU), critically sick pneumonia has a high mortality rate, so forecasting the prognosis is crucial for making decisions. Early detection of clinical deterioration and the implementation of early intervention and care can be achieved through the use of scoring systems. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is a better system in predicting mortality in critically ill patients. However, in this study, we aim to observed  the use of the Sequential Organ Failure Assessment (SOFA) score as a predictor of mortality and length of stay (LOS). Methods: From April to August 2023, we treated 125 critically sick pneumonia patients in the ICU as part of a prospective observational research. An integrated ICU mortality calculator was used to assess the performance of the APACHE II, Simplified Acute Physiology Score II (SAPS II), and SOFA scores. Descriptive statistics will be used for data analysis, and the Fisher exact test and Chi-square test will be used for testing. logistic regression and linear regression methods are used in multivariate analysis. If the p-value is less than 0.05, it will be statistically significant. Results: APACHE II, SAPS II, and SOFA scores were significant in predicting the outcome of critically ill pneumonia patients (cut-off of ≥14.5, ≥34.5, and ≥3.5, respectively). The Spearman rank correlation for LOS shows that APACHE II, SOFA, and SAPS II scores have a very weak relationship with the p-values are 0.121, 0.766, and 0.436, respectively. Conclusion: The SOFA score is a good mortality predictor in critically ill pneumonia patients yet is simpler and easier to use in all settings in the hospital.