Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to...Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.展开更多
目的探讨整合床旁血浆乳酸的序贯性器官功能衰竭评分（quick sequential organ failure assessment,qSOrA）用于急诊科快速评估严重脓毒症患者预后时的应用价值。方法回顾性分析2016年4月-12月四川大学华西医院急诊科收治的严重脓毒症...目的探讨整合床旁血浆乳酸的序贯性器官功能衰竭评分（quick sequential organ failure assessment,qSOrA）用于急诊科快速评估严重脓毒症患者预后时的应用价值。方法回顾性分析2016年4月-12月四川大学华西医院急诊科收治的严重脓毒症患者中资料齐全的821例患者临床数据，其中男性528例、女性293例，年龄（57．5±17．8）岁。计算每个患者的qSOFA评分，联合qSOFA和乳酸的LAC—qSOFA评分以及SOFA评分，通过ROC曲线分别比较三种方法评价严重脓毒症患者28d死亡率和是否入住ICU两个指标，分别计算灵敏度、特异度等指标。结果qSOFA评分，LAC—qSOFA评分以及SOFA评分用于急诊室严重脓毒症患者28d死亡率评估时的ROC曲线下面积分别为O．669，0．690和01772；LAC—qSOFA评分与另外两个评分的的ROC曲线下面积差异均有统计学意义（P〈0．05）。结论LAC—qSOFA评分用于严重脓毒症患者28d死亡率评估时准确度高于qSOFA评分，虽其准确性仍低于SOFA评分，但较SOFA评分简易、快速。展开更多
目的比较序贯器官衰竭评分(sepsis-related organ failure assessment,SOFA)、快速序贯器官衰竭评分(quick sepsis-related organ failure assessment,qSOFA)、改良早期预警评分(modified earl ywarning score,MEWS)和全身炎症反应综合...目的比较序贯器官衰竭评分(sepsis-related organ failure assessment,SOFA)、快速序贯器官衰竭评分(quick sepsis-related organ failure assessment,qSOFA)、改良早期预警评分(modified earl ywarning score,MEWS)和全身炎症反应综合征评分(systemic inflammatory response syndrome,SIRS)对急诊监护室(emergent intensive care unit,EICU)疑似感染患者28 d死亡的预测价值.方法前瞻性队列研究法对在2017年2月至2018年3月期间我院EICU疑似感染患者进行观察.记录临床资料和上述四种评分,随访入EICU 28 d的全因死亡.结果纳入研究的163例疑似感染患者,28d随访中死亡51例(31%).四种评分的曲线下面积(area under curve,AUC)分别为0.782(95% CI 0.711~0.843)、0.704(95% CI 0.628~0.773)、0.640(95% CI 0.562~0.714)和0.516(95% CI 0.436~0.595).结论SOFA评分对EICU疑似感染患者28 d死亡的预测能力最好.展开更多
文摘Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.
文摘目的探讨整合床旁血浆乳酸的序贯性器官功能衰竭评分（quick sequential organ failure assessment,qSOrA）用于急诊科快速评估严重脓毒症患者预后时的应用价值。方法回顾性分析2016年4月-12月四川大学华西医院急诊科收治的严重脓毒症患者中资料齐全的821例患者临床数据，其中男性528例、女性293例，年龄（57．5±17．8）岁。计算每个患者的qSOFA评分，联合qSOFA和乳酸的LAC—qSOFA评分以及SOFA评分，通过ROC曲线分别比较三种方法评价严重脓毒症患者28d死亡率和是否入住ICU两个指标，分别计算灵敏度、特异度等指标。结果qSOFA评分，LAC—qSOFA评分以及SOFA评分用于急诊室严重脓毒症患者28d死亡率评估时的ROC曲线下面积分别为O．669，0．690和01772；LAC—qSOFA评分与另外两个评分的的ROC曲线下面积差异均有统计学意义（P〈0．05）。结论LAC—qSOFA评分用于严重脓毒症患者28d死亡率评估时准确度高于qSOFA评分，虽其准确性仍低于SOFA评分，但较SOFA评分简易、快速。
文摘目的比较序贯器官衰竭评分(sepsis-related organ failure assessment,SOFA)、快速序贯器官衰竭评分(quick sepsis-related organ failure assessment,qSOFA)、改良早期预警评分(modified earl ywarning score,MEWS)和全身炎症反应综合征评分(systemic inflammatory response syndrome,SIRS)对急诊监护室(emergent intensive care unit,EICU)疑似感染患者28 d死亡的预测价值.方法前瞻性队列研究法对在2017年2月至2018年3月期间我院EICU疑似感染患者进行观察.记录临床资料和上述四种评分,随访入EICU 28 d的全因死亡.结果纳入研究的163例疑似感染患者,28d随访中死亡51例(31%).四种评分的曲线下面积(area under curve,AUC)分别为0.782(95% CI 0.711~0.843)、0.704(95% CI 0.628~0.773)、0.640(95% CI 0.562~0.714)和0.516(95% CI 0.436~0.595).结论SOFA评分对EICU疑似感染患者28 d死亡的预测能力最好.
