脓毒症相关器官衰竭快速评估评分在重症监护病房收治菌血症患者中的临床应用:韩国单中心经验

H. Na, E. Jeong, Insu Kim, W. Kim, Kwangha Lee
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引用次数: 4

摘要

背景:我们评估了韩国重症监护病房收治菌血症患者时脓毒症相关器官衰竭快速评估(qSOFA)评分(基于2016年脓毒症定义)的临床实用性。方法回顾性分析2011年3月至2016年2月236例患者的临床资料。除qSOFA外,还计算了修正预警评分(MEWS)和全身炎症反应综合征(SIRS)标准。结果患者中位年龄69岁,男性占61.0%。其中127例(53.8%)qSOFA评分≥2分。他们的脓毒性休克、血小板减少症和高乳酸血症发生率明显增高,在重症监护病房入院后72小时内对呼吸机护理、神经肌肉阻滞剂、血管加压剂和血液透析的需求增加。他们的28天死亡率也明显更高。当使用常见阈值(MEWS≥5和≥2 SIRS标准)进行分析时,MEWS≥5的患者与qSOFA评分≥2的患者结果相同(P < 0.05)。然而,≥2个SIRS标准的患者没有显着差异。结论:我们的研究结果表明,入院时qSOFA评分≥2是预测入院后72小时内疾病严重程度和医疗资源使用以及预测菌血症患者28天死亡率的有用筛查工具。此外,就预后效用而言,qSOFA评分可能比SIRS标准更有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Application of the Quick Sepsis-Related Organ Failure Assessment Score at Intensive Care Unit Admission in Patients with Bacteremia: A Single-Center Experience of Korea
Background We evaluated the clinical usefulness of the quick Sepsis-Related Organ Failure Assessment (qSOFA) score (based on the 2016 definition of sepsis) at intensive care unit admission in Korean patients with bacteremia. Methods We retrospectively analyzed clinical data from 236 patients between March 2011 and February 2016. In addition to the qSOFA, the Modified Early Warning score (MEWS) and systemic inflammatory response syndrome (SIRS) criteria were calculated. Results The patients’ median age was 69 years, and 61.0% were male. Of the patients, 127 (53.8%) had a qSOFA score ≥2 points. They had significantly higher rates of septic shock, thrombocytopenia, and hyperlactatemia, and increased requirements for ventilator care, neuromuscular blocking agents, vasopressors, and hemodialysis within 72 hours after intensive care unit admission. They also had a significantly higher 28-day mortality rate. When analyzed using common thresholds (MEWS ≥5 and ≥2 SIRS criteria), patients with a MEWS ≥5 had the same results as those with a qSOFA score ≥2 (P < 0.05). However, patients with ≥2 SIRS criteria showed no significant differences. Conclusions Our results show that a qSOFA score ≥2 at admission is a useful screening tool for predicting disease severity and medical resource usage within 72 hours after admission, and for predicting 28-day mortality rates in patients with bacteremia. In addition, qSOFA scores may be more useful than SIRS criteria in terms of prognostic utility.
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