Background: The quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) is a simple test to predict in-hospital cardiac arrest (IHCA) from sepsis but its role to predict from overall causes is unknown. The modified early warning score (MEWS) is another scoring system to predict IHCA but a low MEWS cannot rule out IHCA and it is more difficult to calculate than the qSOFA.

Objective: The authors sought to determine the correlation of the qSOFA and 24-hour IHCA with the MEWS.

Materials and Methods: The present report was a retrospective case-control study that included adult patients who had IHCA within 24 hours after presenting to the emergency department (ED). The control cases were randomly selected from ESI levels 1 to 3. The scores were calculated at the initial presentation. The primary outcome was 24-hour IHCA. Predictors of the outcome were identified with binary logistic regression. ROC curves compared the predictive ability.

Results: Of the 19,522 ED visits, 35 patients were enrolled as the study cases and 140 patients as controls. High-risk qSOFA (2 or greater) was a significant predictor for 24-hour IHCA (OR 3.9, 95% CI 1.59 to 9.58) (p<0.05), but high-risk MEWS (5 or greater) was not (OR 1.86, 95% CI 0.83 to 4.11) (p=1.28). The AUC of the qSOFA score was also higher than the MEWS (0.736 versus 0.622) (p<0.05).

Conclusion: High-risk qSOFA is significantly correlated with 24-hour IHCA. The qSOFA scores of 2 or 3 are four times more likely to have 24-hour IHCA than scores of 0 or 1. The qSOFA tends to better predict 24-hour IHCA than the MEWS.

Keywords: qSOFA, MEWS, IHCA, In-hospital cardiac arrest