Abstract

Background: Predicting high-risk mothers in order to prevent the condition from worsening is of utmost importance. Objectives: The present study was aimed to compare SOS, qSOFA, and SOFA scoring systems in the prediction of morbidity and mortality among mothers presenting with sepsis. Materials and Methods: A prospective observational study was conducted from March 2021 to April of 2022 among 164 mothers admitted with maternal sepsis diagnosed by modified SIRS criteria. They were scored with SOS, qSOFA and SOFA scoring systems and followed up for their recovery or death as final outcome to assess the sensitivity, specificity, PPV and NPV. Results: The mean age of the patients was 25.6±3.5 years. Most of the participants were from rural areas, and belonged to the poorer socioeconomic strata. Most of the cases were post-natal sepsis 55.5%; 6.7% were in post-abortal period and the rest of cases 38% were antenatal cases. Of the study participants, 24.2% required intensive care unit admissions, 22% required ventilatory support and 21.3% died as a complication of maternal sepsis. Receiver Operating Characteristic (ROC) curve analysis concluded that SOFA score >13 predicted maternal mortality with sensitivity of 100% and specificity of 86% and qSOFA score >2 predicted maternal mortality with sensitivity 97.1% and specificity of 71.3%. SOFA scores of ≥13 and qSOFA score of ≥2 were having statistically significant association with ICU admission, ventilatory support requirement among patients of maternal sepsis. SOS ≥ 6 on the other hand turned out to be poor predictor of mortality with sensitivity of 42.9% and specificity of 56.6%. SOS also performed poorly in predicting ICU admission and ventilatory support. Conclusion: The findings of the present study establish that amongst SOFA, qSOFA and SOS sepsis scoring system, SOFA (cutoff ≥13) have the best predictive value for maternal sepsis and qSOFA (with cut off ≥2) have comparable predictive values as SOFA. It is also an obvious observation that the qSOFA wins over SOFA in being simpler, yet effective tool to be used in general practice, even at the most primitive healthcare centers.