Objective: The aim of this study was to evaluate the validity and viability of quick SOFA (qSOFA) score, or its variants, as a simple tool for early identification of the risk of death in critically ill canine patients in the emergency department.

Methods: The retrospective study included dogs and cats arrived at the emergency unit between March 2017 and February 2019. For each patient the following data were collected: systolic and mean arterial pressure (SAP, MAP), respiratory rate, heart rate, rectal temperature, Glasgow coma scale (GCS), lactates, base excess, outcome (discharge, death) and diagnosis. For each parameter the best cut-off was found to discriminate between survivors and non-survivors and a score of 1 or 0 was assigned on the basis of the cut-off. Subsequently, for each patient, the classical qSOFA (FR, SAP, GCS) and its variants were evaluated with a ROC test in order to calculate specificity and sensibility.

Results: Of a total of 645 records, 186 dogs (137 survivors and 49 non-survivors) were enrolled.

SAP, GCS, temperature, lactates and base excess resulted significantly different between survivors and non-survivors. Quick SOFA score and the variant with the temperature instead of GCS resulted the scores whit best performance (sensitivity of 52% and specificity of 77%), in identifying the risk of death with a cut-off ≥2. The adjunct of lactate to qSOFA and to the variant with temperature resulted both in 65% sensitivity and 73% specificity and in 34% sensitivity and 95% specificity with a cut-off ≥2 and ≥3, respectively.

Conclusions: In dogs, the classical qSOFA and its variant with temperature resulted in low sensitivity and high specificity, with small capability to early identify emergency patient at risk of death. However, the adjunct of lactate, increases the sensitivity with a small reduction of specificity in identifying patients at risk of death (cut-off ≥2).