[Ability of qSOFA1-lactate to predict 30-day mortality in patients seen for infection in the Emergency Department].

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-08-01 DOI:10.37201/req/008.2023

A Julián-Jiménez, R Rubio-Díaz, J González Del Castillo, E J García-Lamberechts, I Huarte Sanz, C Navarro Bustos, F J Candel, P Angel de Santos, R Alonso Avilés

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引用次数: 0

Abstract

Objective: To evaluate lactate and the Quick Sepsis-Related Organ Failure Assessment (qSOFA) and compare their ability to predict 30-day mortality in patients treated for infection in emergency departments (ED).

Methods: Prospective multicenter observational cohort study. We enrolled a convenience sample of patients aged 18 years or older attended in 71 Spanish ED from October 1, 2019, to March 31, 2020. Each model's predictive power was analyzed with the area under the receiver operating characteristic curve (AUC), and its values of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative (NPV).

Results: A total of 4439 patients with a mean (SD) age of 18 years were studied; 2648 (59.7%) were men and 459 (10.3%) died within 30 days. For 30-day mortality, the AUC-COR obtained with the qSOFA = 1 model plus 2 mmol/l lactate was 0.66 (95% CI, 0.63-0.69) with Se: 68%, Es: 70% and NPV:92%, while qSOFA = 1 obtained AUC-COR of 0.52 (95% CI, 0.49-0.55) with a Se:42%, Es:64% and NPV:90%.

Conclusions: To predict 30-day mortality in patients presenting to the ED due to an episode of infection, the qSOFA =1 + lactate≥2 mmol/L model significantly improves the predictive power achieved individually by qSOFA1 and becomes very similar to qSOFA≥2.

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[qsofa1 -乳酸预测急诊科感染患者30天死亡率的能力]。

目的:评价乳酸和快速败血症相关器官衰竭评估(qSOFA)对急诊科(ED)感染患者30天死亡率的预测能力。方法:前瞻性多中心观察队列研究。我们招募了2019年10月1日至2020年3月31日期间在71家西班牙急诊科就诊的18岁及以上患者作为方便样本。用受试者工作特征曲线下面积(AUC)、敏感性(Se)、特异性(Sp)、阳性预测值(PPV)和阴性预测值(NPV)分析各模型的预测能力。结果:共纳入4439例患者，平均(SD)年龄为18岁;男性2648例(59.7%)，30天内死亡459例(10.3%)。对于30天死亡率，qSOFA = 1模型加2 mmol/l乳酸获得的AUC-COR为0.66 (95% CI, 0.63-0.69)， Se: 68%， Es: 70%， NPV:92%，而qSOFA = 1模型获得的AUC-COR为0.52 (95% CI, 0.49-0.55)， Se:42%， Es:64%， NPV:90%。结论:为了预测因感染而出现ED的患者的30天死亡率，qSOFA =1 +乳酸≥2 mmol/L模型显著提高了qSOFA1单独实现的预测能力，并且变得与qSOFA≥2非常相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.