脓毒症筛查:SIRS还是qSOFA?文献综述。

Benjamin Feist
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引用次数: 7

摘要

2016年,脓毒症和脓毒性休克的定义更新,将脏器功能障碍而不是全身炎症反应作为识别特征。本文旨在比较和评价全身性炎症反应综合征(SIRS)和快速顺序器官衰竭评估(qSOFA)在检测急诊科(ED)患者脓毒症中的有效性。使用四个数据库对文献进行了系统的检索。共鉴定出307件物品。经过筛选,13篇文章符合纳入标准。荟萃分析中出现了五个主题:SIRS;qSOFA;及时性和简洁性;敏感性与特异性;加入乳酸盐。SIRS在评估败血症时为用户提供了更高的灵敏度。然而,qSOFA是一种简单的床边工具,具有更大的特异性,不需要任何血液检查结果。作者创建了一个新的qSOFA筛选工具,其中包括使用即时血清乳酸测定。他发现qSOFA作为ED败血症筛查工具,其疗效、效率和易用性优于SIRS。研究还发现,它可以更好地区分非并发症感染和败血症,后者通常会导致急诊科的疲劳。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Screening for sepsis: SIRS or qSOFA? A literature review.
In 2016, definitions of sepsis and septic shock were updated to focus on organ dysfunction rather than systemic inflammatory response as the identifying trait. This article aims to compare and evaluate the effectiveness of systemic inflammatory response syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) in detecting sepsis in emergency department (ED) patients. A systematic search of the literature was undertaken using four databases. A total of 307 articles was identified. After the selection process, 13 articles met the inclusion criteria for the review. Five themes emerged from the meta-analysis: SIRS; qSOFA; timeliness and simplicity; sensitivity versus specificity; and adding lacate. SIRS offered users greater sensitivity when assessing for sepsis. However, qSOFA is a simple bedside tool with greater specificity, which does not require any blood test results. The author created a new qSOFA screening tool, which incorporated the use of point-of-care serum lactate measurement. He found that qSOFA outperforms SIRS as an ED sepsis screening tool with its strengths of efficacy, efficiency and ease. It was also found to differentiate better between uncomplicated infection and sepsis, which can commonly cause trigger fatigue in EDs.
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