Quick Sequential Organ Failure Assessment (qSOFA) to predict clinical outcome in tsutsugamushi disease patients in emergency department

¹Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
²Department of Emergency Medicine, Konkuk University Chungju Hospital, Chungju, Korea

Correspondence

Dong Wook Lee ,Tel: 041-570-2119, Fax: 041-592-3806, Email: yisfm83@gmail.com,

Received: July 22, 2019; Revised: September 21, 2019 Accepted: October 17, 2019. Published online: February 28, 2020.

ABSTRACT

Objective:
Tsutsugamushi disease is a febrile illness caused by tick bites. Delay in making the diagnosis and treatment cause an increase of the frequency of complications and mortality. The aim of this study was to determine quick sequential organ failure assessment (qSOFA) to predict the clinical outcome of scrub typhus patients in emergency departments.
Method:
This was a retrospective, observational study of patients with tsutsugamushi disease and who presented to the emergency department of an urban hospital and a rural tertiary hospital between January 2013 and December 2018. The demographic and laboratory data was collected through a chart review. Statistical analysis was performed by dividing the patients into the general ward admission group (general ward) and the intensive care unit admission group (ICU).
Results:
Age, Acute Physiology and Chronic Health Evaluation II (APACHE) II score and laboratory tests such as pH, leukocyte count, C-reactive protein, and procalcitonin also showed significant differences between the general ward and ICU groups on the univariable logistic regression analysis, but only the qSOFA score among the variables showed a significant difference on the multivariate logistic regression analysis (P=0.014).
Conclusion:
The qSOFA score will be a prompt and useful tool for predicting the prognosis of patients with tsutsugamushi disease in the emergency department.

Key words: Scrub typhus; APACHE; Organ dysfunction scores