The quick sequential organ failure assessment score as a predictor of mortality in septic dogs.

PICO question: In adult dogs with suspected or confirmed sepsis, does the quick Sequential Organ Failure Assessment (qSOFA) score accurately predict mortality? Clinical bottom line: Category of research: Prognosis. Number and type of study designs reviewed: Four papers were critically reviewed. All four were retrospective cohort studies. Strength of evidence: Weak. Outcomes reported: The use of the quick Sequential Organ Failure Assessment (qSOFA) score to predict mortality of septic dogs in a veterinary hospital setting produced mixed results. When applied generally to dogs admitted to the Intensive Care Unit (ICU) in the first study, there was no significant difference in score between survivors and non-survivors, and this pattern was consistent among the septic dogs in that study. The qSOFA was also not found to be predictive of mortality in dogs with severe sepsis and septic shock in the second study. However, when applied to female dogs referred to a tertiary hospital for pyometra in the third study and dogs with a clinical diagnosis of sepsis requiring surgical source control in the fourth, odds of mortality were higher for scores more than or equal to 2, and discrimination between survivors and non-survivors was good. Conclusion: The available literature does not definitively validate the use of qSOFA as a standalone prognostic tool for dogs with sepsis. It may serve as a supplementary tool for early identification of at-risk patients; however, it should not replace clinician judgment in decision-making. As is the case when applied to humans in the literature, the score may be used in conjunction with other observations to aid in clinical decision-making, but a negative result should not delay investigations or treatments. A higher score or an increase in score may be used to identify patients at risk of deterioration to trigger further investigations and consideration of possible infection. The qSOFA should only be used as a complementary tool to assist with management and monitoring, not to determine prognosis for individual patients.