快速序列性器官衰竭评估得分是皮肤性利切除术后感染性休克的更好预测:两项多中心前性试验的二次分析
Jillian J Gerrity1, Jonathan H Berger2, Ryan S Hsi3
1University of California, San Diego School of Medicine, San Diego, California, USA.
Journal of endourology
|June 9, 2023
概括
在前性数据中,快速序列性器官衰竭评估 (qSOFA) 评分显示,在预测皮肤透神经切除手术 (PCNL) 后预测败血症休克时,其特异性高于系统性炎症反应综合征 (SIRS) 标准.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 透皮瘤切除术 (PCNL) 后的感染性休克预测对于患者的治疗结果至关重要.
- 系统性炎症反应综合征 (SIRS) 标准和快速序列性器官衰竭评估 (qSOFA) 用于败血症评估.
- 之前的回顾性研究表明,qSOFA在PCNL后的败血性休克预测方面可能优于SIRS.
研究的目的:
- 为了前性地评估和比较qSOFA和SIRS标准的诊断准确性,以预测PCNL后的败血性休克.
- 确定两种评分系统的灵敏度和特异性,以识别需要入住重症监护室 (ICU) 进行PCNL后血管压力支持的患者.
主要方法:
- 两项前性多中心研究的二次分析,涉及9个机构的218名PCNL患者.
- 对SIRS和qSOFA评分的临床数据在术后第一天前性收集.
- 测量的主要结果是SIRS和qSOFA (≥2分) 的灵敏度和特异性,用于预测血管压缩剂支持的ICU入院.
主要成果:
- 只有一个患者 (0.46%) 需要进入ICU进行血管压缩器支持.
- 根据SIRS标准,其灵敏度为100%,特异性为72.4% (p < 0.001).
- qSOFA表现出100%的灵敏度和90.8%的更高的特异性 (p < 0.001).
结论:
- 虽然这个队列中qSOFA和SIRS的积极预测值很低,但qSOFA为预测PCNL后败血性休克提供了更好的特异性.
- 前性数据表明,qSOFA可能是比SIRS更具特异性的工具,用于早期识别PCNL后有感染性休克风险的患者.
- 进一步的研究可能会完善qSOFA在这个特定的手术群体中的实用性.
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