qSOFA, lactate, SIRS, and NLR for mortality prediction in critically ill dogs and cats
Veterinary world · 2026
In plain language
This study followed very sick dogs and cats, including 37 cats, for 21 days after admission to a critical-care unit. In cats, 21-day survival was 43.2%. The study does not say whether any cats had FeLV, so it does not show what these markers mean for FeLV-positive cats.
Scientific detail
This prospective clinical study evaluated 76 client-owned critically ill animals, including 39 dogs and 37 cats, admitted to a critical-care unit. The primary outcome was survival status 21 days after admission. Overall 21-day survival was 47.4%, with 43.2% survival in the feline subgroup.
Among the evaluated markers, qSOFA showed the best prognostic performance for mortality prediction in this cohort, with an AUC of 0.72. Adding lactate to qSOFA produced a slightly higher AUC, but the improvement was not statistically significant. SIRS and NLR showed limited discriminative ability and poor overall predictive performance in this study.
The relevance to FeLV is indirect only. The source includes cats and evaluates mortality prediction in a critical-care setting, which may be indirectly relevant if a FeLV-positive cat becomes critically ill. However, the source does not mention FeLV, FeLV-positive cats, retroviral disease, antiviral treatment, or FeLV-specific outcomes.
Comparative evidence in mixed populations of critically ill small animals remains limited, and the provided source content does not report additional limitations. From this source, it cannot be established whether qSOFA, lactate, SIRS, or NLR predict mortality specifically in FeLV-positive cats.
What we know
In this prospective cohort of 76 critically ill dogs and cats, including 37 cats, qSOFA had the best prognostic performance among the evaluated markers for mortality prediction, with AUC 0.72. Feline 21-day survival was 43.2%. Adding lactate to qSOFA slightly increased the AUC, without a statistically significant improvement. SIRS and NLR performed poorly as predictors in this population.
What we don't know
This source does not show whether any cats had FeLV, whether FeLV affected survival, or whether qSOFA, lactate, SIRS, or NLR predict mortality specifically in FeLV-positive cats. It also provides no data on antiviral treatment, retroviral disease, or FeLV-specific outcomes.
Evidence
EvidenceLevel C — Preliminary evidenceConfidence 97/100
This study prospectively evaluated 76 critically ill client-owned dogs and cats, including 37 cats, admitted to a critical-care unit.
Excerpt verified in the source — verbatim, in the source's own language“A prospective cohort study was conducted on 76 client-owned critically ill animals, including 39 dogs and 37 cats, admitted to the CCU of the Small Animal Hospital, Chiang Mai University, Thailand.”
This establishes the study population and design. It does not establish FeLV status, FeLV-specific prognosis, or any treatment effect.
EvidenceLevel C — Preliminary evidenceConfidence 98/100
The primary outcome was survival status 21 days after admission.
Excerpt verified in the source — verbatim, in the source's own language“Survival status at 21 days post-admission was used as the primary outcome measure.”
This identifies the measured outcome for prognostic evaluation. It does not report cause-specific mortality or FeLV-related mortality.
EvidenceLevel C — Preliminary evidenceConfidence 98/100
Overall 21-day survival was 47.4%, with 43.2% survival reported in cats.
Excerpt verified in the source — verbatim, in the source's own language“The overall 21-day survival rate was 47.4%, with survival rates of 51.3% in dogs and 43.2% in cats.”
This reports survival rates in the mixed cohort and the feline subgroup. It does not indicate how many animals had FeLV or whether FeLV influenced survival.
EvidenceLevel C — Preliminary evidenceConfidence 96/100
qSOFA showed the best prognostic performance among the evaluated markers for mortality prediction in this cohort, with AUC 0.72.
Excerpt verified in the source — verbatim, in the source's own language“qSOFA demonstrated the best prognostic performance for mortality prediction, with an AUC of 0.72 (95% confidence interval [CI]: 0.61-0.82).”
This supports qSOFA as the best-performing evaluated prognostic marker in this study population. It does not prove it is optimal in all cats, in FeLV-positive cats, or as a basis for treatment decisions.
EvidenceLevel C — Preliminary evidenceConfidence 98/100
Adding lactate to qSOFA produced a slightly higher AUC, but the improvement was not statistically significant.
Excerpt verified in the source — verbatim, in the source's own language“The combined qSOFA+lactate model produced a slightly higher AUC of 0.75 (95% CI: 0.62-0.88), although the improvement was not statistically significant.”
This indicates that the combined model did not clearly outperform qSOFA alone statistically. It does not support lactate as a stand-alone treatment target or clinical intervention.
EvidenceLevel C — Preliminary evidenceConfidence 97/100
SIRS and NLR had limited discriminative ability and poor overall predictive performance in this study.
Excerpt verified in the source — verbatim, in the source's own language“SIRS and NLR exhibited limited discriminative ability and poor overall predictive performance.”
This supports limited prognostic value for SIRS and NLR in the evaluated cohort. It does not rule out utility in other populations or FeLV-specific contexts.
InferenceConfidence 95/100
The findings are only indirectly relevant to FeLV because the source does not state that any cats had FeLV or that FeLV-specific outcomes were assessed.
The source includes cats but does not mention FeLV. Therefore, applying these findings to FeLV-positive cats would require additional evidence.
Open questionConfidence 96/100
Whether qSOFA, lactate, SIRS, or NLR predict mortality specifically in FeLV-positive cats remains unknown from this source.
The provided content does not report FeLV status or FeLV subgroup analyses, so FeLV-specific prognostic performance cannot be established.
Provenance
Source: Comparative prognostic performance of quick sequential organ failure assessment, lactate, systemic inflammatory response syndrome criteria, and neutrophil-to-lymphocyte ratio for mortality prediction in critically ill dogs and cats.
AVA