Background Major Trauma is the leading cause of death in patients aged between 1 and 39 years and accounts for 8% of deaths worldwide. Several prognostic tools have been developed to predict the outcome of Major Trauma patients that present acutely to hospital.

Aims The aim is to assess the prognostic accuracy of the qSOFA score in both the Pre-Hospital and Emergency Department (ED) setting in predicting mortality in Major Trauma patients.

Methods This is a retrospective single-centre study of consecutive Major Trauma patients presenting to a tertiary university hospital. Patients were identified using the Trauma Audit and Research Network (TARN) database. TARN collects data on Major Trauma patients that are admitted to hospital. Patients that were discharged between September 1st 2013 and December 31st 2021 were eligible for inclusion. The database was interrogated for relevant data points including Prehospital and ED qSOFA, Injury Severity Score (ISS), Probability of Survival (PS) and outcome (eg death or discharge location).

Results 3069 patients were included in the study. There was a higher mortality rate for patients with a qSOFA of ≥ 2 (13.8% for Pre-Hospital, 15.7% for ED qSOFAs) compared to compared to those with a qSOFA score of < 2 (3.7% for Pre-Hospital, 3.6% for ED qSOFAs) [p<0.001]. The sensitivity for the ED qSOFA score (AUC of 0.70) was higher than the Pre-Hospital qSOFA score, ISS and PS. There was a lower PS in those with a qSOFA ≥2. This also correlates with a higher median ISS of 10 in those with ED qSOFA ≥ 2 compared to the other qSOFA scores. There was a higher rate of ICU admissions in those with ED qSOFA score ≥ 2 (12.4%) compared to those with ED qSOFA score <2 (8.0%)

Conclusion The qSOFA is potentially useful in predicting mortality of Major Trauma patients.