快速败血症相关器官功能衰竭评估评分的老年参数对预测急诊科疑似感染的老年患者临床病情恶化的额外价值：一项前瞻性观察研究的事后分析。

Q3 Medicine

Acute Medicine Pub Date : 2024-01-01 DOI:10.52964/AMJA.0989

Agneta H Calf, Hjalmar R Bouma, Liann Weil, Emma M de Jong, Marije de Haan, Barbara C van Munster, Jan C Ter Maaten

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引用次数: 0

摘要

目的：研究老年病参数（如身体损伤）对快速器官功能衰竭序列评估（qSOFA）工具预测疑似感染的急诊室老年患者临床病情恶化的附加价值，并验证最终预测模型：方法：对一家大学医院急诊室就诊的成年患者进行前瞻性观察性队列研究的事后多变量回归分析，以建立预测模型。利用前瞻性数据库Acutelines对预测模型进行了外部验证：在老年患者中，qSOFA（OR 1.47 (95% CI 1.12-1.95)）和体力损伤（OR 1.84 (95% CI 1.20-2.82)）与 72 小时内的临床恶化密切相关。由此得出的预测模型在衍生队列中的曲线下面积为 0.62（95% CI 0.56-0.68），在验证队列中的曲线下面积为 0.62（95% CI 0.56-0.68）。该模型的校准效果不佳：结论：在疑似感染的急诊室老年患者中，不仅疾病严重程度评分与临床恶化有关，身体损伤也与临床恶化密切相关。

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Additional value of geriatric parameters to Quick Sepsis Related Organ Failure Assessment score for predicting clinical deterioration in older emergency department patients with a suspected infection: post-hoc analysis of a prospective observational study.

Aim: To investigate the additional value of geriatric parameters such as physical impairment to the quick Sequential Organ Failure Assessment (qSOFA) tool for predicting clinical deterioration in older ED patients with a suspected infection and to validate the final prediction model.

Methods: Post-hoc multivariable regression analysis from a prospective observational cohort study of adult patients visiting the ED of a university hospital to develop a prediction model. External validation of the prediction model was performed using the prospective data-biobank Acutelines.

Results: In older patients, qSOFA (OR 1.47 (95% CI 1.12-1.95)) and physical impairment (OR 1.84 (95% CI 1.20-2.82)) were independently associated with clinical deterioration within 72 hours. This resulted in a prediction model with an area under the curve of 0.62 (95% CI 0.56-0.68) in the derivation cohort, and of 0.62 (95% CI 0.56-0.68) in the validation cohort. Calibration of the model was poor.

Conclusion: In older ED patients with a suspected infection, not only disease severity scores, but also presence of physical impairment is independently associated with clinical deterioration.

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来源期刊

Acute Medicine Medicine-Emergency Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： These are usually commissioned by the editorial team in accordance with a cycle running over several years. Authors wishing to submit a review relevant to Acute Medicine are advised to contact the editor before writing this. Unsolicited review articles received for consideration may be included if the subject matter is considered of interest to the readership, provided the topic has not already been covered in a recent edition. Review articles are usually 3000-5000 words and may include tables, pictures and other figures as required for the text. Include 3 or 4 ‘key points’ summarising the main teaching messages.