Sepsis and septic shock originating from the urinary tract and male reproductive organs account for 9–31% of all sepsis cases. The mortality rate for septic shock from UTIs is recorded at 30–40%, which remains alarmingly high, necessitating early diagnosis and effective treatment. The SOFA (Sequential Organ Failure Assessment) score, introduced in 2016, has been widely applied in intensive care units (ICUs) to enable early detection of sepsis and septic shock. However, reports on the application of qSOFA and SOFA scores for sepsis cases specifically originating from the urinary tract are limited. This study aims to assess the application of qSOFA and SOFA scores in the diagnosis and management of sepsis and septic shock from UTIs at the Ho Chi Minh City University Medical Center.

A retrospective case series was conducted, including patients diagnosed with sepsis and septic shock at HCMC-UMC from September 2022 to September 2023.

The study included 119 cases of sepsis and septic shock from UTIs, with 25 cases (21%) categorized as septic shock. The average patient age was 65.6 ± 12.3 years (range: 32–93). The male-to-female ratio was 1:2. Common symptoms included fever (79%) and chills (68.9%). Escherichia coli was the most commonly isolated pathogen in blood cultures (58.4%) and urine cultures (52.8%). Carbapenems were the primary empirical antibiotics used (75%), with concordance to antibiograms in 88.3% of cases. Surgical interventions were performed in 28 cases (23.5%), including ureteral stent placement in 20 cases and other procedures. The mean hospital stay was 11.8 ± 6.54 days. The qSOFA and SOFA scores were significant predictors of mortality, with each point increase correlating to a 3.64-fold and 1.82-fold increase in mortality risk, respectively.

The qSOFA and SOFA scores are effective tools for diagnosing and predicting mortality in hospitalized patients with sepsis and septic shock due to UTIs.