Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study
Abstract Background In veterinary medicine, the qSOFA model has been studied in patients with conditions such as peritonitis or pyometra, and among the modified qSOFA models, only the qSOFA-lactate model has been researched. Thus, this study aimed to evaluate the effectiveness of q-SOFA-C-reactive p...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12917-025-04689-w |
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| author | Soyeon Gwak HyunJung Han |
| author_facet | Soyeon Gwak HyunJung Han |
| author_sort | Soyeon Gwak |
| collection | DOAJ |
| description | Abstract Background In veterinary medicine, the qSOFA model has been studied in patients with conditions such as peritonitis or pyometra, and among the modified qSOFA models, only the qSOFA-lactate model has been researched. Thus, this study aimed to evaluate the effectiveness of q-SOFA-C-reactive protein (CRP), qSOFA-lactate, and quick systemic inflammatory response syndrome (qSIRS) models for triaging emergency and critically ill patients. These models were juxtaposed with conventional systems (SIRS, qSOFA, and acute patient physiology and laboratory evaluation [APPLE] fast) to ascertain their efficacy in patient triage and prognostication. In this retrospective cohort study, data from 166 dogs admitted to the Department of Emergency and Critical care at Konkuk Veterinary Medical Teaching Hospital between February 2021 and May 2023 were analyzed. Scoring systems were computed based on initial admission physical examinations (respiratory rate, heart rate, temperature, mentation, and systolic blood pressure) and laboratory results (white blood cell and platelet count and albumin, glucose, lactate, and CRP levels). Because no prior veterinary studies on the qSOFA-CRP model were available, optimal cutoff values were established using receiver operating characteristic (ROC) curves and the Youden index. Conventional scoring systems were compared with the modified qSOFA within the survivor and non-survivor groups. The most effective system was determined through ROC curve analysis. Results For the qSOFA-CRP model, we identified an optimal cutoff value for CRP at > 1.55 mg/dL. All modified qSOFA scoring systems showed significant differences between survivors and non-survivors, in contrast to the conventional scoring systems. Notably, the qSOFA-CRP model demonstrated the highest area under the ROC curve value (0.761, 95% CI 0.68–0.83) and odds ratio (13.373, p < 0.001) when evaluating mortality at 28 days. Conclusions The qSOFA-CRP model, when employing a CRP threshold of 1.55 mg/dL, demonstrated promising potential as a novel criterion for triaging emergency and critically ill patients. However, further assessment is required in a larger population of patients at the precise early stage of sepsis. |
| format | Article |
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| institution | OA Journals |
| issn | 1746-6148 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Veterinary Research |
| spelling | doaj-art-801f8e40267744448b48eb64a8e67f4f2025-08-20T02:11:47ZengBMCBMC Veterinary Research1746-61482025-04-0121111010.1186/s12917-025-04689-wEvaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective studySoyeon Gwak0HyunJung Han1Department of Veterinary Emergency and Critical Care, College of Veterinary Medicine, Konkuk UniversityDepartment of Veterinary Emergency and Critical Care, College of Veterinary Medicine, Konkuk UniversityAbstract Background In veterinary medicine, the qSOFA model has been studied in patients with conditions such as peritonitis or pyometra, and among the modified qSOFA models, only the qSOFA-lactate model has been researched. Thus, this study aimed to evaluate the effectiveness of q-SOFA-C-reactive protein (CRP), qSOFA-lactate, and quick systemic inflammatory response syndrome (qSIRS) models for triaging emergency and critically ill patients. These models were juxtaposed with conventional systems (SIRS, qSOFA, and acute patient physiology and laboratory evaluation [APPLE] fast) to ascertain their efficacy in patient triage and prognostication. In this retrospective cohort study, data from 166 dogs admitted to the Department of Emergency and Critical care at Konkuk Veterinary Medical Teaching Hospital between February 2021 and May 2023 were analyzed. Scoring systems were computed based on initial admission physical examinations (respiratory rate, heart rate, temperature, mentation, and systolic blood pressure) and laboratory results (white blood cell and platelet count and albumin, glucose, lactate, and CRP levels). Because no prior veterinary studies on the qSOFA-CRP model were available, optimal cutoff values were established using receiver operating characteristic (ROC) curves and the Youden index. Conventional scoring systems were compared with the modified qSOFA within the survivor and non-survivor groups. The most effective system was determined through ROC curve analysis. Results For the qSOFA-CRP model, we identified an optimal cutoff value for CRP at > 1.55 mg/dL. All modified qSOFA scoring systems showed significant differences between survivors and non-survivors, in contrast to the conventional scoring systems. Notably, the qSOFA-CRP model demonstrated the highest area under the ROC curve value (0.761, 95% CI 0.68–0.83) and odds ratio (13.373, p < 0.001) when evaluating mortality at 28 days. Conclusions The qSOFA-CRP model, when employing a CRP threshold of 1.55 mg/dL, demonstrated promising potential as a novel criterion for triaging emergency and critically ill patients. However, further assessment is required in a larger population of patients at the precise early stage of sepsis.https://doi.org/10.1186/s12917-025-04689-wSepsisInflammationC-reactive protein |
| spellingShingle | Soyeon Gwak HyunJung Han Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study BMC Veterinary Research Sepsis Inflammation C-reactive protein |
| title | Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study |
| title_full | Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study |
| title_fullStr | Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study |
| title_full_unstemmed | Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study |
| title_short | Evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients: a retrospective study |
| title_sort | evaluation of the modified quick sequential organ failure assessment scoring system for triage and prognostic assessment in canine emergency and critically ill patients a retrospective study |
| topic | Sepsis Inflammation C-reactive protein |
| url | https://doi.org/10.1186/s12917-025-04689-w |
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