导出和验证一种查工具的中风相关性败血症的衍生和验证
Sebastian Stösser1, Lisa Kleusch2, Alina Schenk3
1Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. sebastian.stoesser@ukbonn.de.
Neurological research and practice
|July 12, 2023
概括
一个新的中风-SOFA (S-SOFA) 评分有助于识别非重症监护病房 (ICU) 中高风险败血症和不良结果的中风患者. 这一分数是管理ICU以外的中风相关感染的宝贵工具.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 脑卒中后的感染可能导致败血症,这是一种与不良临床结果相关的疾病.
- 败血症的特征是危及生命的器官功能障碍,通常使用顺序器官衰竭评估 (SOFA) 评分进行评估.
- 标准的SOFA分数对于在重症监护室 (ICU) 不管理的患者具有有限的适用性.
研究的目的:
- 开发和验证针对中风患者量身定制的修改后,用户友好的SOFA评分.
- 改善败血症的识别和预测中风患者的不良结果,特别是那些在ICU之外的人.
主要方法:
- 基于注册表的212名患有大血管封闭性中风和感染的患者队列被用来制定得分.
- 后勤回归分析确定了与败血症相关的不良结果的预测因素.
- 开发的得分在391名患有缺血性中风和感染的患者的单独队列上得到了验证.
主要成果:
- 脑卒中-SOFA (S-SOFA) 评分结合了美国国立卫生研究院的脑卒中评分,外周氧和,平均动脉压,血小板数和肌素水平.
- 在预测不良结果方面,S-SOFA 评分表现与标准 SOFA 评分相当 (AUC 0.713 与 0.750).
- 最重要的是,S-SOFA得分证明在非ICU患者中不低于SOFA得分,特别是非ICU患者.
结论:
- S-SOFA评分为识别非ICU中风患者的相关性败血症提供了一个实用工具,这些患者有很高的不良结果风险.
- 这一修改后的得分提高了在重症监护机构之外,在中风患者中管理和监测败血症的能力.
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