ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Lactate and Procalcitonin Combined with qSOFA Score for the Evaluation of Disease Severity and Prognosis in ICU Patients with Sepsis: A Retrospective Study
Provisionally accepted
- Zhongshan Hospital, Xiamen University, Xiamen, China
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Background: Sepsis remains a leading cause of mortality among ICU patients, and early prognostic assessment is essential for improving outcomes. Although the quick Sequential Organ Failure Assessment (qSOFA) score is widely used for bedside risk stratification, its standalone predictive performance is limited. Integrating biochemical markers such as lactate and procalcitonin (PCT) may improve prognostic accuracy. This study was designed to evaluate the combined value of qSOFA, lactate, and PCT in assessing disease severity and mortality risk, and to clarify the prognostic utility of dynamic monitoring at multiple time points. Methods: This retrospective study included 128 ICU patients with sepsis, categorized into qSOFA <2 (n = 57) and qSOFA ≥2 (n = 71) groups. Lactate and PCT levels were recorded at ICU admission (T0), 24 hours (T24), and 72 hours (T72). ICU mortality, 28-day mortality, ICU length of stay, and multiple organ failure rates were analyzed. Multivariate logistic regression was performed with adjustment for age, hypertension, and SOFA score. Receiver operating characteristic (ROC) curves were used to compare the predictive performance of qSOFA alone and in combination with the biomarkers. Results: Patients with qSOFA ≥2 had significantly higher ICU and 28-day mortality (P < 0.05) and exhibited consistently elevated lactate and PCT levels at all three time points (P < 0.01). qSOFA, lactate, and PCT were independent predictors of both ICU and 28-day mortality (P < 0.05). The combined model demonstrated superior discrimination, with AUCs of 0.79 for ICU mortality and 0.81 for 28-day mortality, outperforming qSOFA alone or qSOFA paired with a single biomarker. Conclusion: A qSOFA score ≥2 identifies patients at higher risk of mortality. Dynamic monitoring of lactate and PCT significantly enhances early prognostic evaluation, and their combined use with qSOFA provides improved risk stratification for ICU patients with sepsis.
Keywords: qSOFA, Lactate, Procalcitonin, dynamic monitoring, Sepsis, prognosis
Received: 10 Oct 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Tan, Chen and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xianjin Zhang, zsyyjz2120@xmu.edu.cn
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