SynthesisPloS one2025
Predictive value of SOFA, PCT, Lactate, qSOFA and their combinations for mortality in patients with sepsis: A systematic review and meta-analysis.
Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Factors associated with mortality in older sepsis patients: a nationwide retrospective cohort study in Germany.Age and ageing · 2026Observational
- The incremental prognostic value of platelet-to-neutrophil and platelet-to-lymphocyte ratios in patients with sepsis: A retrospective cohort study.The Journal of international medical research · 2026Article
- Association Between Serum Phosphorus and 28-Day Mortality in Patients with Bloodstream Infection: Potential Prognostic Implication Beyond Renal Function and Clinical Severity.Pathogens (Basel, Switzerland) · 2026Article
- Challenges in early detection and prognostication of sepsis: new approaches from the emergency department and intensive care unit.EClinicalMedicine · 2026Review
- Implementation of a Sepsis Code Protocol at an Academic Institution in Colombia: A Pilot Study.Journal of clinical medicine · 2026Article
- Shock index-modified qSOFA improves mortality risk stratification in patients with sepsis beyond conventional qSOFA.Frontiers in medicine · 2026Article
- 28-Day Mortality and Prognostic Factors in COPD Patients with Sepsis: A Retrospective Study Using eICU-CRD Database.International journal of chronic obstructive pulmonary disease · 2026Article
- Nomogram analysis of factors associated with prognosis in patients with sepsis-associated acute kidney injury: a case-control study based on LASSO regression.Frontiers in medicine · 2026Article
- Article
- Association of glucose-lymphocyte ratio and short-term mortality in patients with sepsis complicated by ARDS during the acute phase: a multicenter retrospective cohort study.Frontiers in cellular and infection microbiology · 2026Observational
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5 authors.
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Abstract
backgroundSepsis is a leading cause of death, necessitating early prediction of mortality risk.
objectiveTo systematically review the predictive efficacy of the Sequential Organ Failure Assessment (SOFA), procalcitonin (PCT), lactate, quick Sequential Organ Failure Assessment (qSOFA), and lactate-adjusted qSOFA (LqSOFA) for the risk of death in patients with sepsis.
methodsAccording to PRISMA-DTA guidelines, PubMed, Embase, the Cochrane Library, and CNKI were searched (up to March 2025), and 29 studies were included (n = 41,469). A bivariate random-effects model was used to pool the sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve (AUROC). The ΔAUROC was compared using a random-effects model based on a paired-data design. Heterogeneity was evaluated by I² (>50%) and Cochrane's Q test.
resultsSOFA demonstrated superior predictive efficacy (AUROC = 0.819, 95% CI: 0.783-0.850; sensitivity = 0.77, 95% CI: 0.71-0.82; specificity = 0.73, 95% CI: 0.67-0.79), significantly outperforming PCT (ΔAUROC = 0.10, 95% CI: 0.04-0.16), lactate (ΔAUROC = 0.07, 95% CI: 0.03-0.11), and qSOFA (ΔAUROC = 0.08, 95% CI: 0.05-0.11). LqSOFA (AUROC = 0.823, 95% CI: 0.787-0.854) demonstrated efficacy comparable to SOFA (ΔAUROC = 0.02, 95% CI: -0.02-0.06) and significantly superior to qSOFA (ΔAUROC = 0.06, 95% CI: 0.04-0.08), with a sensitivity of 0.46 (0.24-0.69) and specificity of 0.88 (0.80-0.93). Subgroup analyses revealed sustained high performance in both emergency department (ED) settings (AUROC = 0.82, 95% CI: 0.79-0.85) and low- and middle-income countries (LMICs) (AUROC = 0.81, 95% CI: 0.77-0.84).
conclusionSOFA remains the optimal predictor of sepsis mortality risk. qSOFA demonstrates suboptimal overall predictive ability, whereas LqSOFA achieves comparable accuracy to SOFA by combining the advantages of lactate and qSOFA. Its high specificity may be valuable for rapid risk exclusion in resource-limited settings (ED/LMICs). Future studies should validate LqSOFA across diverse clinical settings and underrepresented LMIC regions and should integrate dynamic lactate clearance metrics.
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