Prognostic Value of SIRS, SOFA, qSOFA, and LqSOFA in Emergency Department Sepsis Patients and Correlation of Cytokine Patterns With In-Hospital Mortality
Bibliographic record
Abstract
Background: Several prognostic scores and molecular patterns have been developed to predict increased in-hospital mortality in septic patients. This prospective study aimed to evaluate the prognostic value of systemic inflammatory response syndrome (SIRS), Sequential Organ Failure Assessment (SOFA), quick SOFA (qSOFA), lactate quick SOFA (LqSOFA) and cytokine production levels in emergency department sepsis patients to predict in-hospital mortality. Methods: A total of 106 septic patients were enrolled. Baseline SOFA, SIRS, qSOFA and LqSOFA scores were calculated, and plasma levels of interleukin (IL)-6, IL-10, tumor necrosis factor-α (TNF-α) and interleukin-33 receptor (IL-33R) were measured on admission. Results: SOFA, qSOFA, LqSOFA scores were significantly lower in sepsis survivors. IL-33R levels were significantly higher in non-survivors (P = 0.021). The best predictive score for sepsis based on the area under the receiver operating characteristic (ROC) curve was qSOFA (0.764, 95% confidence interval (CI) = 0.663 - 0.866), followed by LqSOFA (0.738, 95% CI = 0.63 - 0.845), SOFA (0.713, 95% CI = 0.604 - 0.822) and SIRS (0.603, 95% CI = 0.478 - 0.729). The addition of IL-33R levels (cut-off values > 55,393 pg/mL) to qSOFA and SOFA significantly increased the diagnostic accuracy of both scores with area under the curve (AUC) of 0.78 (95% CI = 0.695 - 0.85) and 0.740 (95% CI = 0.636 - 0.844), respectively. When evaluating early (within 72 h) in-hospital mortality, both IL-10 and IL-33R were significantly higher in non-survivors (124 pg/mL vs. 41 pg/mL in survivors, 195,610 pg/mL vs. 62,767 pg/mL in survivors, respectively). When added to qSOFA and SOFA scores (cut-off levels 74.5 pg/mL and 55,393 pg/mL for IL-10 and IL-33R, respectively), they significantly increased their diagnostic accuracy. Conclusions: Sepsis prognostic scores were significantly lower in sepsis survivors. IL-10 levels had a significant impact in predicting early (within 72 h) in-hospital mortality and IL-33R levels in predicting both early and total in-hospital mortality, especially when combined with SOFA and qSOFA scores.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".