Lactate-enhanced-qSOFA (LqSOFA) score as a predictor of in-hospital mortality in patients with sepsis: systematic review and meta-analysis.

Abstract

Introduction: Sepsis is a systemic process that refers to a deregulated immune response of the host against an infectious agent, involving multiple organ dysfunction. It is rapidly progressive and has a dismal prognosis, with high mortality rates. For this reason, it is necessary to have a tool for early recognition of these patients, with the aim of treating them appropriately in a timely manner.

Methods: This research is a systematic review based on bibliography indexed in four online scientific databases for studies published since inception to February 2024, which was obtained through the use of a search strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.

Results: The meta-analysis revealed that among 23,551 patients diagnosed with sepsis, 5,825 had a positive LqSOFA, and 3,086 experienced the primary outcome (mortality). For LqSOFA, a sensitivity of 0.61 (95% CI 0.60-0.63), specificity of 0.81 (95% CI 0.80-0.81), positive likelihood ratio (LR+) of 3.46 (95% CI 2.86-4.18), negative likelihood ratio (LR-) of 0.47 (95% CI 0.38-0.59), and odds ratio (OR) of 7.43 (95% CI 6.01-9.20) were determined. The area under the curve (AUC) was 0.807.

Conclusions: The LqSOFA score demonstrates a good predictive capacity for in-hospital mortality in septic patients, showing clinically significant levels of sensitivity (69%) and specificity (79%).