在预测印度急诊室败血症患者的死亡率方面，国家早期预警评分2优于快速顺序器官衰竭评估：一项前瞻性观察性研究。

Q3 Medicine

International Journal of Critical Illness and Injury Science Pub Date : 2023-01-01 Epub Date: 2023-03-24 DOI:10.4103/ijciis.ijciis_41_22

Ankur Verma, Aasiya Farooq, Sanjay Jaiswal, Meghna Haldar, Wasil Rasool Sheikh, Palak Khanna, Amit Vishen, Rinkey Ahuja, Abbas Ali Khatai, Nilesh Prasad

{"title":"在预测印度急诊室败血症患者的死亡率方面，国家早期预警评分2优于快速顺序器官衰竭评估：一项前瞻性观察性研究。","authors":"Ankur Verma, Aasiya Farooq, Sanjay Jaiswal, Meghna Haldar, Wasil Rasool Sheikh, Palak Khanna, Amit Vishen, Rinkey Ahuja, Abbas Ali Khatai, Nilesh Prasad","doi":"10.4103/ijciis.ijciis_41_22","DOIUrl":null,"url":null,"abstract":"Background: High in-hospital mortality in sepsis patients remains challenging for clinicians worldwide. Early recognition, prognostication, and aggressive management are essential for treating septic patients. Many scores have been formulated to guide clinicians to predict the early deterioration of such patients. Our objective was to compare predictive values of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2) with respect to in-hospital mortality.Methods: This prospective observational study was conducted in a tertiary care center in India. Adults with suspected infection with at least two Systemic Inflammatory Response Syndrome criteria presenting to the emergency department (ED) were enrolled. NEWS2 and qSOFA scores were calculated, and patients were followed until their primary outcome of mortality or hospital discharge. The diagnostic accuracy of qSOFA and NEWS2 for predicting mortality was analyzed.Results: Three hundred and seventy-three patients were enrolled. Overall mortality was 35.12%. A majority of patients had LOS between 2 and 6 days (43.70%). NEWS2 had higher area under curve at 0.781 (95% confidence interval [CI] (0.59, 0.97)) than qSOFA at 0.729 (95% CI [0.51, 0.94]), with P < 0.001. Sensitivity, specificity, and diagnostic efficiency to predict mortality by NEWS2 were 83.21% (95% CI [83.17%, 83.24%]); 57.44% (95% CI [57.39%, 57.49%]); and 66.48% (95% CI [66.43%, 66.53%]), respectively. qSOFA score had sensitivity, specificity, and diagnostic efficiency to predict mortality of 77.10% (95% CI [77.06%, 77.14%]); 42.98% (95% CI [42.92%, 43.03%]); and 54.95% (95% CI [54.90%, 55.00%]), respectively.Conclusion: NEWS2 is superior to qSOFA in predicting in-hospital mortality for sepsis patients presenting to the ED in India.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"26-31"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167809/pdf/","citationCount":"0","resultStr":"{\"title\":\"National Early Warning Score 2 is superior to quick Sequential Organ Failure Assessment in predicting mortality in sepsis patients presenting to the emergency department in India: A prospective observational study.\",\"authors\":\"Ankur Verma, Aasiya Farooq, Sanjay Jaiswal, Meghna Haldar, Wasil Rasool Sheikh, Palak Khanna, Amit Vishen, Rinkey Ahuja, Abbas Ali Khatai, Nilesh Prasad\",\"doi\":\"10.4103/ijciis.ijciis_41_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: High in-hospital mortality in sepsis patients remains challenging for clinicians worldwide. Early recognition, prognostication, and aggressive management are essential for treating septic patients. Many scores have been formulated to guide clinicians to predict the early deterioration of such patients. Our objective was to compare predictive values of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2) with respect to in-hospital mortality.Methods: This prospective observational study was conducted in a tertiary care center in India. Adults with suspected infection with at least two Systemic Inflammatory Response Syndrome criteria presenting to the emergency department (ED) were enrolled. NEWS2 and qSOFA scores were calculated, and patients were followed until their primary outcome of mortality or hospital discharge. The diagnostic accuracy of qSOFA and NEWS2 for predicting mortality was analyzed.Results: Three hundred and seventy-three patients were enrolled. Overall mortality was 35.12%. A majority of patients had LOS between 2 and 6 days (43.70%). NEWS2 had higher area under curve at 0.781 (95% confidence interval [CI] (0.59, 0.97)) than qSOFA at 0.729 (95% CI [0.51, 0.94]), with P < 0.001. Sensitivity, specificity, and diagnostic efficiency to predict mortality by NEWS2 were 83.21% (95% CI [83.17%, 83.24%]); 57.44% (95% CI [57.39%, 57.49%]); and 66.48% (95% CI [66.43%, 66.53%]), respectively. qSOFA score had sensitivity, specificity, and diagnostic efficiency to predict mortality of 77.10% (95% CI [77.06%, 77.14%]); 42.98% (95% CI [42.92%, 43.03%]); and 54.95% (95% CI [54.90%, 55.00%]), respectively.Conclusion: NEWS2 is superior to qSOFA in predicting in-hospital mortality for sepsis patients presenting to the ED in India.\",\"PeriodicalId\":13938,\"journal\":{\"name\":\"International Journal of Critical Illness and Injury Science\",\"volume\":\"13 1\",\"pages\":\"26-31\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167809/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Critical Illness and Injury Science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/ijciis.ijciis_41_22\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/3/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Critical Illness and Injury Science","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ijciis.ijciis_41_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/3/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

背景：败血症患者的高住院死亡率对全世界的临床医生来说仍然是一个挑战。早期识别、预测和积极管理对治疗败血症患者至关重要。已经制定了许多评分来指导临床医生预测此类患者的早期病情恶化。我们的目的是比较快速序贯器官衰竭评估（qSOFA）和国家早期预警评分2（NEWS2）对住院死亡率的预测价值。方法：这项前瞻性观察性研究在印度的一家三级护理中心进行。在急诊科就诊的疑似感染至少符合两种全身炎症反应综合征标准的成年人被纳入研究。计算NEWS2和qSOFA评分，并对患者进行随访，直到其死亡或出院的主要结果。分析qSOFA和NEWS2预测死亡率的诊断准确性。结果：共有373名患者入选。总死亡率为35.12%。大多数患者的LOS发生在2至6天之间（43.70%）。NEWS2的曲线下面积为0.781（95%置信区间[CI]（0.59，0.97）），高于qSOFA的0.729（95%置信度[0.51，0.94]），P＜0.001。NEWS2预测死亡率的敏感性、特异性和诊断效率为83.21%（95%CI[83.17%，83.24%]）；57.44%（95%CI[57.39%，57.49%]）；和66.48%（95%CI[66.43%，66.53%]）。qSOFA评分预测死亡率的敏感性、特异性和诊断效率为77.10%（95%CI[77.06%，77.14%]）；42.98%（95%CI为42.92%，43.03%]）；和54.95%（95%CI[54.90%，55.00%）。结论：在预测印度ED败血症患者的住院死亡率方面，NEWS2优于qSOFA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

National Early Warning Score 2 is superior to quick Sequential Organ Failure Assessment in predicting mortality in sepsis patients presenting to the emergency department in India: A prospective observational study.

查看原文本刊更多论文

Background: High in-hospital mortality in sepsis patients remains challenging for clinicians worldwide. Early recognition, prognostication, and aggressive management are essential for treating septic patients. Many scores have been formulated to guide clinicians to predict the early deterioration of such patients. Our objective was to compare predictive values of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2) with respect to in-hospital mortality.

Methods: This prospective observational study was conducted in a tertiary care center in India. Adults with suspected infection with at least two Systemic Inflammatory Response Syndrome criteria presenting to the emergency department (ED) were enrolled. NEWS2 and qSOFA scores were calculated, and patients were followed until their primary outcome of mortality or hospital discharge. The diagnostic accuracy of qSOFA and NEWS2 for predicting mortality was analyzed.

Results: Three hundred and seventy-three patients were enrolled. Overall mortality was 35.12%. A majority of patients had LOS between 2 and 6 days (43.70%). NEWS2 had higher area under curve at 0.781 (95% confidence interval [CI] (0.59, 0.97)) than qSOFA at 0.729 (95% CI [0.51, 0.94]), with P < 0.001. Sensitivity, specificity, and diagnostic efficiency to predict mortality by NEWS2 were 83.21% (95% CI [83.17%, 83.24%]); 57.44% (95% CI [57.39%, 57.49%]); and 66.48% (95% CI [66.43%, 66.53%]), respectively. qSOFA score had sensitivity, specificity, and diagnostic efficiency to predict mortality of 77.10% (95% CI [77.06%, 77.14%]); 42.98% (95% CI [42.92%, 43.03%]); and 54.95% (95% CI [54.90%, 55.00%]), respectively.

Conclusion: NEWS2 is superior to qSOFA in predicting in-hospital mortality for sepsis patients presenting to the ED in India.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

International Journal of Critical Illness and Injury Science Medicine-Emergency Medicine

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： IJCIIS encourages research, education and dissemination of knowledge in the field of Critical Illness and Injury Science across the world thus promoting translational research by striking a synergy between basic science, clinical medicine and public health. The Journal intends to bring together scientists and academicians in the emergency intensive care and promote translational synergy between Laboratory Science, Clinical Medicine and Public Health. The Journal invites Original Articles, Clinical Investigations, Epidemiological Analysis, Data Protocols, Case Reports, Clinical Photographs, review articles and special commentaries. Students, Residents, Academicians, Public Health experts and scientists are all encouraged to be a part of this initiative by contributing, reviewing and promoting scientific works and science.