The Utility of Initial Lactate for the Quick Sequential Organ Failure Assessment (LqSOFA) in Emergency Septic Patients
Authors: Saqer M. Althunayyan, Ahmed Abdullah Aledeny, Mohammed A. Malabarey, et al.
Journal: American Journal of Emergency Medicine, 2025 Feb 25
Conclusions:
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LqSOFA demonstrates stronger predictive performance than qSOFA, particularly for mortality.
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While qSOFA remains more specific, LqSOFA's higher sensitivity makes it more useful for early identification of high-risk septic patients.
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Future prospective, multiregional studies are needed to validate LqSOFA’s clinical utility.
Methods:
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Study Design: Retrospective, observational cohort study.
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Setting: Four branches of Dr. Sulaiman Al-Habib Medical Group (HMG) in Riyadh, Saudi Arabia (May 2022–April 2023).
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Population:
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1274 adult patients with suspected sepsis.
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Mean age: 68.8 ± 17.9 years.
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Male predominance: 59.2% (n = 754).
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Analysis:
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Initial LqSOFA and qSOFA scores were calculated.
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Sensitivity, specificity, and AUROC (area under the receiver operator characteristic curve) were compared for both scoring systems regarding ICU admission, vasopressor use, and 72-hour mortality.
Results:
Sensitivity & Specificity:
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LqSOFA had higher sensitivity than qSOFA for predicting all outcomes:
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ICU Admission: 48% vs. 30%
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Vasopressor Requirement: 68% vs. 50%
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Mortality: 76% vs. 71%
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qSOFA had higher specificity than LqSOFA:
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ICU Admission: 89% vs. 81%
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Vasopressor Requirement: 83% vs. 71%
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Mortality: 80% vs. 67%
AUROC (Predictive Performance):
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LqSOFA had a greater AUROC than qSOFA for all outcomes.
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The difference was statistically significant for mortality prediction (p < 0.05).
Althunayyan, S.M., Aledeny, A.A., Malabarey, M.A., Alshaqaqiq, A.I., Haj-Ali, E.O., Alhomsi, M.W., Elgazar, H.K., Alrefaei, T.S. and AlAsiri, S.A., 2025. The utility of initial lactate for the quick sequential organ failure assessment (LqSOFA) for emergency septic patients. The American Journal of Emergency Medicine.