The Use of qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS) to Predict Severe Complications in Hematologic Malignancy Patients.

Open Access Emergency Medicine : OAEM Pub Date : 2022-02-05 eCollection Date: 2022-01-01 DOI:10.2147/OAEM.S345308

Pungkava Sricharoen, Chaithawat Chueluecha, Chaiyaporn Yuksen, Chetsadakon Jenpanitpong

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Abstract

Background: Sepsis causes high mortality in vulnerable groups such as hematologic malignancy (HM) patients. There are various early warning scores of sepsis, eg, qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS). This study aimed to compare REWS, qSOFA, and SOFA in predicting severe complications in hematologic malignancy patients visiting ED.

Methods: The study was conducted as a retrospective cohort study at the ED of Ramathibodi Hospital, Bangkok, Thailand. Adult HM patients suspected of sepsis and have visited ED between March 2016 and December 2019.

Results: Among 124 patients in our cohort, 51 (41%) had serious complication in ED and 20 (16%) died within 28 days after admission. The AUROCs of SOFA and qSOFA indicate significantly higher predicting in serious complication in ED than REWS (SOFA, 0.81 [95% CI, 0.73-0.89], qSOFA, 0.73 [95% CI, 0.65-0.81], REWS, 0.62 [95% CI, 0.52-0.72] p=0.004) while the predicting in 28-day mortality is not statistically significantly different (SOFA, 0.73 [95% CI, 0.60-0.85], qSOFA, 0.69 [95% CI, 0.58-0.80], REWS, 0.60 [95% CI, 0.44-0.75] p=0.25).

Conclusion: The SOFA score is highest in predicting severe complications among hematologic malignancy patients.

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应用qSOFA、SOFA和Ramathibodi早期预警评分(REWS)预测血液病恶性患者的严重并发症

背景:败血症在血液恶性肿瘤(HM)患者等易感人群中引起高死亡率。脓毒症有多种早期预警评分，如qSOFA、SOFA和Ramathibodi早期预警评分(REWS)。本研究旨在比较REWS、qSOFA和SOFA在预测血液恶性肿瘤急诊科患者严重并发症方面的作用。方法:该研究是在泰国曼谷Ramathibodi医院急诊科进行的回顾性队列研究。疑似脓毒症并于2016年3月至2019年12月期间就诊于急诊科的成年HM患者。结果:124例患者中，51例(41%)有严重的ED并发症，20例(16%)在入院后28天内死亡。SOFA和qSOFA的auroc对ED严重并发症的预测明显高于REWS (SOFA, 0.81 [95% CI, 0.73-0.89]， qSOFA, 0.73 [95% CI, 0.65-0.81]， REWS, 0.62 [95% CI, 0.52-0.72] p=0.004)，而对28天死亡率的预测差异无统计学意义(SOFA, 0.73 [95% CI, 0.60-0.85]， qSOFA, 0.69 [95% CI, 0.58-0.80]， REWS, 0.60 [95% CI, 0.44-0.75] p=0.25)。结论:SOFA评分是预测恶性血液病患者严重并发症的最高评分。

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Open Access Emergency Medicine : OAEM

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