Lactate Enhanced Quick Sequential Organ Failure Assessment Score (Lqsofa) as a Tool to Predict the Prognosis in Patients of Sepsis in Surgical Intensive Care Unit

Objectives Sepsis is a life-threatening condition involving organ dysfunction due to an abnormal host response to infection. This study aims to assess the quick Sequential Organ Failure Assessment (qSOFA) score and serum lactate levels in patients with sepsis admitted to the Surgical ICU. It further aims to evaluate the prognostic accuracy of q-SOFA and serum lactate individually, as well as to determine the predictive value of their combined use in the same patient population. Various tools like the sequential organ failure assessment (SOFA) and qSOFA scores aid prognosis; their utility can be improved by integrating lactate levels. Recent studies suggest the Lactate-Enhanced qSOFA (LqSOFA) score enhances the accuracy of predicting outcomes in sepsis, highlighting its potential in critical care settings like the SICU. Material and Methods The study prospectively enrolled patients with sepsis admitted to the surgical intensive care unit (SICU), following informed written consent. Serum lactate levels and q-SOFA scores were assessed within the first 24 hours of admission. Patients were monitored throughout their hospital stay, with outcomes recorded as in-hospital mortality and length of SICU stay. Data were documented using a structured proforma, and the investigator covered the cost of serum lactate tests. Statistical analysis included univariate analysis and area under the receiver operating characteristic (AUROC) curve generation to evaluate and compare the predictive accuracy of q-SOFA, serum lactate, and LqSOFA scores for the defined outcomes. Results This study evaluated the prognostic performance of qSOFA, serum lactate, and LqSOFA in 107 SICU patients with sepsis. LqSOFA demonstrated superior predictive accuracy for in-hospital mortality and SICU stay, with an area under the curve (AUC) of 0.831, outperforming qSOFA (0.793) and lactate (0.727). Elevated lactate levels were significantly associated with worse outcomes, while LqSOFA provided enhanced sensitivity and specificity when stratifying risk. These findings support the integration of lactate into qSOFA to improve clinical decision-making, particularly in resource-limited settings. Further research should validate LqSOFA across broader populations and clinical environments to guide early intervention and optimize patient outcomes. Conclusion This study demonstrates that the LqSOFA score offers superior prognostic performance over qSOFA and serum lactate individually predicting in-hospital mortality and SICU length of stay among surgical sepsis patients. Its ease of use, bedside applicability, and enhanced predictive accuracy make it a valuable tool for routine clinical practice. Further prospective, multicentric investigations are recommended to confirm these findings and to evaluate the generalizability of LqSOFA across different patient populations and healthcare systems.