Julian Orlando Casallas-Barrera, Darlyng Aireth Zabala-Muñoz, Carol Viviana Aponte-Carrascal, Angie Marcela Ochoa-Ricardo, Edgar Felipe Quintero-Varela, Juan Nicolas Quiñones-Romero, Jenny Paola Garzón-Ruiz, Edwin Silva-Monsalve, Ricardo Buitrago-Bernal
{"title":"预测心脑血管合并脓毒症和脓毒性休克患者的死亡率：NEWS-2是否优于qSOFA、SOFA和qPitt？一项观察性研究。","authors":"Julian Orlando Casallas-Barrera, Darlyng Aireth Zabala-Muñoz, Carol Viviana Aponte-Carrascal, Angie Marcela Ochoa-Ricardo, Edgar Felipe Quintero-Varela, Juan Nicolas Quiñones-Romero, Jenny Paola Garzón-Ruiz, Edwin Silva-Monsalve, Ricardo Buitrago-Bernal","doi":"10.1177/20499361251323207","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sepsis is one of the leading causes of morbidity and mortality worldwide. Early detection and reliable prediction of sepsis-related mortality are crucial. The prognostic value of National Early Warning Score 2 (NEWS-2) in sepsis patients with cardiovascular and neurovascular diseases is not well elucidated.</p><p><strong>Objectives: </strong>This study aims to evaluate and compare the qSOFA, SOFA, qPitt, and NEWS-2 scores for predicting mortality in sepsis and septic shock patients.</p><p><strong>Design: </strong>An observational retrospective study was conducted involving patients with sepsis or septic shock.</p><p><strong>Methods: </strong>Data were collected between 2023 and 2024. Baseline measures included sociodemographic and clinical characteristics. All subjects were identified from a database of a highly complex healthcare institution focused on the diagnosis and treatment of cardiovascular and neurovascular diseases. The scores qSOFA, SOFA, NEWS-2, and qPitt were collected from medical records and analyzed. A sample size was estimated. The area under the receiver operating characteristic curve (AUROC) analysis was established for each score. A multivariate analysis adjusted for confounding factors through logistic regression was performed.</p><p><strong>Results: </strong>A total of 126 participants were included, with a median age of 72 years (IQR: 59-81), and 76 (60.32%) being men. The overall mortality rate in the population was 19.8%, with 84% of deaths occurring in males. Statistically significant differences in variables such as heart failure, mild liver disease, and atrial fibrillation were observed between the groups (<i>p</i> < 0.05). The NEWS-2 score with a cut-off point of ⩾8 showed a significant association with mortality (<i>p</i> = 0.0001). The AUROC for NEWS-2 was 0.80, compared to a ROC of 0.6960 for qPitt, 0.6776 for SOFA, and 0.5868 for qSOFA (χ<sup>2</sup> = 16.60, Prob > χ<sup>2</sup> = 0.0009).</p><p><strong>Conclusion: </strong>NEWS 2 exhibits better performance in predicting mortality among elderly adults with cardiovascular and neurovascular diseases suffering from sepsis or septic shock, compared to the qPitt, SOFA, and qSOFA scores.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251323207"},"PeriodicalIF":3.8000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946295/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prediction of mortality in cardio-neurovascular patients with sepsis and septic shock: is NEWS-2 better than qSOFA, SOFA, and qPitt? An observational study.\",\"authors\":\"Julian Orlando Casallas-Barrera, Darlyng Aireth Zabala-Muñoz, Carol Viviana Aponte-Carrascal, Angie Marcela Ochoa-Ricardo, Edgar Felipe Quintero-Varela, Juan Nicolas Quiñones-Romero, Jenny Paola Garzón-Ruiz, Edwin Silva-Monsalve, Ricardo Buitrago-Bernal\",\"doi\":\"10.1177/20499361251323207\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sepsis is one of the leading causes of morbidity and mortality worldwide. Early detection and reliable prediction of sepsis-related mortality are crucial. The prognostic value of National Early Warning Score 2 (NEWS-2) in sepsis patients with cardiovascular and neurovascular diseases is not well elucidated.</p><p><strong>Objectives: </strong>This study aims to evaluate and compare the qSOFA, SOFA, qPitt, and NEWS-2 scores for predicting mortality in sepsis and septic shock patients.</p><p><strong>Design: </strong>An observational retrospective study was conducted involving patients with sepsis or septic shock.</p><p><strong>Methods: </strong>Data were collected between 2023 and 2024. Baseline measures included sociodemographic and clinical characteristics. All subjects were identified from a database of a highly complex healthcare institution focused on the diagnosis and treatment of cardiovascular and neurovascular diseases. The scores qSOFA, SOFA, NEWS-2, and qPitt were collected from medical records and analyzed. A sample size was estimated. The area under the receiver operating characteristic curve (AUROC) analysis was established for each score. A multivariate analysis adjusted for confounding factors through logistic regression was performed.</p><p><strong>Results: </strong>A total of 126 participants were included, with a median age of 72 years (IQR: 59-81), and 76 (60.32%) being men. The overall mortality rate in the population was 19.8%, with 84% of deaths occurring in males. Statistically significant differences in variables such as heart failure, mild liver disease, and atrial fibrillation were observed between the groups (<i>p</i> < 0.05). The NEWS-2 score with a cut-off point of ⩾8 showed a significant association with mortality (<i>p</i> = 0.0001). The AUROC for NEWS-2 was 0.80, compared to a ROC of 0.6960 for qPitt, 0.6776 for SOFA, and 0.5868 for qSOFA (χ<sup>2</sup> = 16.60, Prob > χ<sup>2</sup> = 0.0009).</p><p><strong>Conclusion: </strong>NEWS 2 exhibits better performance in predicting mortality among elderly adults with cardiovascular and neurovascular diseases suffering from sepsis or septic shock, compared to the qPitt, SOFA, and qSOFA scores.</p>\",\"PeriodicalId\":46154,\"journal\":{\"name\":\"Therapeutic Advances in Infectious Disease\",\"volume\":\"12 \",\"pages\":\"20499361251323207\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-03-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946295/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Infectious Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20499361251323207\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Infectious Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20499361251323207","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Prediction of mortality in cardio-neurovascular patients with sepsis and septic shock: is NEWS-2 better than qSOFA, SOFA, and qPitt? An observational study.
Background: Sepsis is one of the leading causes of morbidity and mortality worldwide. Early detection and reliable prediction of sepsis-related mortality are crucial. The prognostic value of National Early Warning Score 2 (NEWS-2) in sepsis patients with cardiovascular and neurovascular diseases is not well elucidated.
Objectives: This study aims to evaluate and compare the qSOFA, SOFA, qPitt, and NEWS-2 scores for predicting mortality in sepsis and septic shock patients.
Design: An observational retrospective study was conducted involving patients with sepsis or septic shock.
Methods: Data were collected between 2023 and 2024. Baseline measures included sociodemographic and clinical characteristics. All subjects were identified from a database of a highly complex healthcare institution focused on the diagnosis and treatment of cardiovascular and neurovascular diseases. The scores qSOFA, SOFA, NEWS-2, and qPitt were collected from medical records and analyzed. A sample size was estimated. The area under the receiver operating characteristic curve (AUROC) analysis was established for each score. A multivariate analysis adjusted for confounding factors through logistic regression was performed.
Results: A total of 126 participants were included, with a median age of 72 years (IQR: 59-81), and 76 (60.32%) being men. The overall mortality rate in the population was 19.8%, with 84% of deaths occurring in males. Statistically significant differences in variables such as heart failure, mild liver disease, and atrial fibrillation were observed between the groups (p < 0.05). The NEWS-2 score with a cut-off point of ⩾8 showed a significant association with mortality (p = 0.0001). The AUROC for NEWS-2 was 0.80, compared to a ROC of 0.6960 for qPitt, 0.6776 for SOFA, and 0.5868 for qSOFA (χ2 = 16.60, Prob > χ2 = 0.0009).
Conclusion: NEWS 2 exhibits better performance in predicting mortality among elderly adults with cardiovascular and neurovascular diseases suffering from sepsis or septic shock, compared to the qPitt, SOFA, and qSOFA scores.
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