It is crucial to rapidly identify sepsis so that adequate treatment may be initiated. Accordingly, the Sequential Organ Failure Assessment (SOFA) and the quick SOFA (qSOFA) scores are used to evaluate intensive care unit (ICU) and non-ICU patients, respectively. As demand for ICU beds rises, the intermediate care unit (IMCU) carries greater importance as a bridge between the ICU and the regular ward. This study aimed to examine the ability of SOFA and qSOFA scores to predict suspected infection and mortality in IMCU patients. Retrospective data analysis included 13,780 surgical patients treated at the IMCU, ICU, or both between January 01, 2012, and September 30, 2018. Patients were screened for suspected infection (i.e., the commencement of broad-spectrum antibiotics) and then evaluated for the SOFA score, qSOFA score, and the 1992 defined systemic inflammatory response syndrome (SIRS) criteria. Suspected infection was detected in 1306 (18.3%) of IMCU, 1365 (35.5%) of ICU, and 1734 (62.0%) of IMCU/ICU encounters. Overall, 458 (3.3%) patients died (IMCU 45 [0.6%]; ICU 250 [6.5%]; IMCU/ICU 163 [5.8%]). All investigated scores failed to predict suspected infection independently of the analyzed subgroup. Regarding mortality prediction, the qSOFA score performed sufficiently within the IMCU cohort (AUCROC SIRS 0.72 [0.71–0.72]; SOFA 0.52 [0.51–0.53]; qSOFA 0.82 [0.79–0.84]), while the SOFA score was predictive in patients of the IMCU/ICU cohort (AUCROC SIRS 0.54 [0.53–0.54]; SOFA 0.73 [0.70–0.77]; qSOFA 0.59 [0.58–0.59]). None of the assessed scores was sufficiently able to predict suspected infection in surgical ICU or IMCU patients. While the qSOFA score is appropriate for mortality prediction in IMCU patients, SOFA score prediction quality is increased in critically ill patients.

中文翻译：

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qSOFA评分、SOFA评分和SIRS标准预测外科中级和重症监护患者感染和死亡率的比较

快速识别败血症至关重要，以便可以开始适当的治疗。因此，顺序器官衰竭评估 (SOFA) 和快速 SOFA (qSOFA) 评分分别用于评估重症监护病房 (ICU) 和非 ICU 患者。随着对 ICU 病床需求的增加，中间监护病房 (IMCU) 作为 ICU 和普通病房之间的桥梁变得越来越重要。本研究旨在检查 SOFA 和 qSOFA 评分预测 IMCU 患者疑似感染和死亡率的能力。回顾性数据分析包括 2012 年 1 月 1 日至 2018 年 9 月 30 日期间在 IMCU、ICU 或两者同时接受治疗的 13,780 名手术患者。 SOFA 评分、qSOFA 评分、和 1992 年定义的全身炎症反应综合征 (SIRS) 标准。在 1306 名 IMCU（18.3%）、1365 名（35.5%）ICU 和 1734 名（62.0%）IMCU/ICU 遭遇中检测到疑似感染。总体而言，458 (3.3%) 名患者死亡（IMCU 45 [0.6%]；ICU 250 [6.5%]；IMCU/ICU 163 [5.8%]）。所有调查的分数都未能独立于分析的亚组预测疑似感染。关于死亡率预测，qSOFA 评分在 IMCU 队列中表现良好（AUCROC SIRS 0.72 [0.71–0.72]；SOFA 0.52 [0.51–0.53]；qSOFA 0.82 [0.79–0.84]），而 SOFA 评分在以下患者中具有预测性IMCU/ICU 队列（AUCROC SIRS 0.54 [0.53–0.54]；SOFA 0.73 [0.70–0.77]；qSOFA 0.59 [0.58–0.59]）。评估的评分均无法充分预测外科 ICU 或 IMCU 患者的疑似感染。