{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:56:33Z","timestamp":1791122193861,"version":"4.1.0"},"reference-count":15,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,9]]},"abstract":"<jats:p>The quick sequential organ failure assessment (qSOFA) score has been proposed for risk stratification of emergency room patients with suspected infection. Its use of simple bedside observations makes qSOFA an attractive option for resource-limited regions. We prospectively assessed the predictive ability of qSOFA compared with systemic inflammatory response syndrome (SIRS), universal vital assessment (UVA), and modified early warning score (MEWS) in a resource-limited setting in Lambar\u00e9n\u00e9, Gabon. In addition, we evaluated different adaptations of qSOFA and UVA in this cohort and an external validation cohort from Malawi. We included 279 cases, including 183 with an ad hoc (suspected) infectious disease diagnosis. Overall mortality was 5%. In patients with an infection, oxygen saturation, mental status, human immunodeficiency virus (HIV) status, and all four risk stratification score results differed significantly between survivors and non-survivors. The UVA score performed best in predicting mortality in patients with suspected infection, with an area under the receiving operator curve (AUROC) of 0.90 (95% confidence interval [CI]: 0.78\u20131.0, <jats:italic>P<\/jats:italic> &lt; 0.0001), outperforming qSOFA (AUROC 0.77; 95% CI: 0.63\u20130.91, <jats:italic>P<\/jats:italic> = 0.0003), MEWS (AUROC 0.72; 95% CI: 0.58\u20130.87, <jats:italic>P<\/jats:italic> = 0.01), and SIRS (AUROC 0.70; 95% CI: 0.52\u20130.88, <jats:italic>P<\/jats:italic> = 0.03). An amalgamated qSOFA score applying the UVA thresholds for blood pressure and respiratory rate improved predictive ability in Gabon (AUROC 0.82; 95% CI: 0.68\u20130.96) but performed poorly in a different cohort from Malawi (AUROC 0.58; 95% CI: 0.51\u20130.64). In conclusion, UVA had the best predictive ability, but multicenter studies are needed to validate the qSOFA and UVA scores in various settings and assess their impact on patient outcome.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0577","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T07:00:44Z","timestamp":1543302044000},"page":"202-208","source":"Crossref","is-referenced-by-count":23,"title":["A Prospective Comparison of Quick Sequential Organ Failure Assessment, Systemic Inflammatory Response Syndrome Criteria, Universal Vital Assessment, and Modified Early Warning Score to Predict Mortality in Patients with Suspected Infection in Gabon"],"prefix":"10.4269","volume":"100","author":[{"given":"Manus","family":"Schmedding","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;"},{"name":"Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9, Lambar\u00e9n\u00e9, Gabon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayode R.","family":"Adegbite","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;"},{"name":"Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9, Lambar\u00e9n\u00e9, Gabon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Gould","sequence":"additional","affiliation":[{"name":"Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9, Lambar\u00e9n\u00e9, Gabon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin O.","family":"Beyeme","sequence":"additional","affiliation":[{"name":"Albert Schweitzer Hospital, Lambar\u00e9n\u00e9, Gabon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akim A.","family":"Adegnika","sequence":"additional","affiliation":[{"name":"Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9, Lambar\u00e9n\u00e9, Gabon;"},{"name":"German Center for Infection Research, Institute of Tropical Medicine, University of T\u00fcbingen and Partner site T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P.","family":"Grobusch","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;"},{"name":"Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9, Lambar\u00e9n\u00e9, Gabon;"},{"name":"German Center for Infection Research, Institute of Tropical Medicine, University of T\u00fcbingen and Partner site T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u00ebla A. M.","family":"Huson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"JAMA","first-page":"801","article-title":"The third international consensus definitions for sepsis and septic shock (sepsis-3)","volume":"315","author":"Singer","year":"2016"},{"key":"b2","series-title":"JAMA","first-page":"762","article-title":"Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic Shock (sepsis-3)","volume":"315","author":"Seymour","year":"2016"},{"key":"b3","series-title":"Crit Care","first-page":"28","article-title":"Performance of the quick sequential (sepsis-related) organ failure assessment score as a prognostic tool in infected patients outside the intensive care unit: a systematic review and meta-analysis","volume":"22","author":"Song","year":"2018"},{"key":"b4","series-title":"Ann Intern Med","first-page":"266","article-title":"Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection: a systematic review and meta-analysis","volume":"168","author":"Fernando","year":"2018"},{"key":"b5","series-title":"Chest","first-page":"646","article-title":"A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis","volume":"153","author":"Serafim","year":"2018"},{"key":"b6","series-title":"Clin Microbiol Infect","first-page":"1123","article-title":"Accuracy of quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for predicting mortality in hospitalized patients with suspected infection: a meta-analysis of observational studies","volume":"24","author":"Maitra","year":"2018"},{"key":"b7","series-title":"Travel Med Infect Dis","first-page":"76","article-title":"Predictive value of the qSOFA score in patients with suspected infection in a resource limited setting in Gabon","volume":"15","author":"Huson","year":"2017"},{"key":"b8","series-title":"Infection","first-page":"893","article-title":"Application of the qSOFA score to predict mortality in patients with suspected infection in a resource-limited setting in Malawi","volume":"45","author":"Huson","year":"2017"},{"key":"b9","series-title":"Am J Emerg Med","first-page":"2010","article-title":"Mortality outcomes based on ED qSOFA score and HIV status in a developing low income country","volume":"36","author":"Aluisio","year":"2018"},{"key":"b10","series-title":"PLoS One","first-page":"e0197982","article-title":"Prognostic value of quickSOFA as a predictor of 28-day mortality among febrile adult patients presenting to emergency departments in Dar es Salaam, Tanzania","volume":"13","author":"Boillat-Blanco","year":"2018"},{"key":"b11","series-title":"JAMA","first-page":"2202","article-title":"Association of the quick sequential (sepsis-related) organ failure assessment (qSOFA) score with excess hospital mortality in adults with suspected infection in low- and middle-income countries","volume":"319","author":"Rudd","year":"2018"},{"key":"b12","series-title":"Crit Care Med","first-page":"724","article-title":"Definitions for sepsis and organ failure","volume":"20","author":"Bone","year":"1992"},{"key":"b13","series-title":"QJM","first-page":"521","article-title":"Validation of a modified early warning score in medical admissions","volume":"94","author":"Subbe","year":"2001"},{"key":"b14","series-title":"BMJ Glob Health","first-page":"e000344","article-title":"Derivation and validation of a universal vital assessment (UVA) score: a tool for predicting mortality in adult hospitalised patients in sub-Saharan 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