脓毒症鉴定工具:叙述回顾。

IF 2 4区 医学 Q3 CRITICAL CARE MEDICINE
Maureen A Seckel, Joanna D Lejnieks
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引用次数: 0

摘要

背景:虽然脓毒症仍然是一种医学紧急情况,但没有诊断的标准测试。目前的脓毒症管理指南强烈建议进行脓毒症筛查,但没有确定具体使用的工具。目的:总结脓毒症筛查工具和触发因素的证据,确定当前使用的工具,并描述其有效性。方法:回顾2019年1月至2024年6月的文献。如果研究描述了用于急诊科成人或成年住院患者(包括重症监护病房患者)的败血症筛查工具,则纳入研究。如果研究描述了与人工智能或生物标志物和生物制剂相关的机器学习专用工具,则将其排除在外。结果:共筛选300篇文献。最后一组26项研究包括计算机临床决策支持系统(8项研究)、现有早期预警系统(14项研究)和新的或新颖的工具(4项研究)。脓毒症的定义是异质的,通常基于疾病分类代码、脓毒症-2或脓毒症-3定义的标准或其组合。最常用的早期预警系统工具是国家早期预警评分版本1和版本2。很少有证据支持使用快速序贯[败血症相关]器官衰竭评估单独进行败血症鉴定。计算机临床决策支持系统的使用是多种多样的;专有的和个别系统开发的工具都是可用的,在报告准确性的标准上几乎没有共识。结论:很明显,目前所有可用的工具仅作为临床敏锐度的辅助工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sepsis Identification Tools: A Narrative Review.

Background: Although sepsis remains a medical emergency, there is no standard test for diagnosing it. Current sepsis management guidelines strongly recommend screening for sepsis but do not identify a specific tool to use.

Objective: To summarize the evidence for sepsis screening tools and triggers, identify the current tools used, and describe their effectiveness.

Methods: A review of the literature from January 2019 through June 2024 was performed. Studies were included if they described sepsis screening tools used for adults in the emergency department or adult inpatients, including intensive care unit patients. Studies were excluded if they described tools specific to machine learning with artificial intelligence or biomarkers and biologics.

Results: A total of 300 articles were screened. The final set of 26 studies included articles on computerized clinical decision support systems (8 studies), existing early warning systems (14 studies), and new or novel tools (4 studies). Sepsis definitions were heterogeneous and generally based on disease classification codes, criteria from the Sepsis-2 or Sepsis-3 definitions, or combinations thereof. The most commonly used early warning system tools used that had superior evidence were the National Early Warning Score versions 1 and 2. Little evidence supported the use of the quick Sequential [Sepsis-related] Organ Failure Assessment alone for sepsis identification. The use of computerized clinical decision support systems is varied; both proprietary and individual system-developed tools are available, with little consensus on standards for reporting accuracy.

Conclusion: It is clear that all currently available tools function only as adjuncts to clinical acumen.

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来源期刊
Critical care nurse
Critical care nurse 医学-护理
CiteScore
2.80
自引率
0.00%
发文量
68
审稿时长
>12 weeks
期刊介绍: Critical Care Nurse (CCN) is an official publication of the American Association of Critical-Care Nurses (AACN). Authors are invited to submit manuscripts for consideration and peer review. Clinical topics must meet the mission of CCN and address nursing practice of acute and critically ill patients.
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