我们可以在没有肺炎严重性指数的情况下识别严重的社区性肺炎吗? 使用经过修改的qSOFA与prcalcitonin一起使用
Tolgahan Güleç1, Sarper Yılmaz2, Rohat Ak3
1University of Health Sciences, Dept. of Emergency Medicine, Adiyaman Education and Research Hospital, Adiyaman, Turkey.
快速序列性器官衰竭评估 (qSOFA) 和公素 (PCT) 的结合有效地识别了严重的社区获得性肺炎 (CAP). 这种qSOFA + PCT得分证明比其他评分系统更可靠,用于诊断严重的CAP.
科学领域:
- 紧急医疗 紧急医疗
- 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:
- 社区获得性肺炎 (CAP) 是疾病和死亡的一个重要原因.
- 准确及时诊断严重的CAP对于适当的患者管理和改善结果至关重要.
- 现有的分数系统,如qSOFA和NEWS在识别严重的CAP方面具有不同程度的有效性.
研究的目的:
- 为了评估qSOFA的诊断性能,修改了qSOFA,NEWS和NEWS+乳酸盐得分,用于检测严重的CAP.
- 为了比较这些分数的准确性,单独和与乳酸和PCT等生物标志物相结合,用于严重的CAP检测.
主要方法:
- 对在急诊室被诊断患有CAP的患者进行了一项回顾性队列研究.
- 根据肺炎严重性指数 (PSI) 评分,患者被分为重度和轻度的CAP组.
- 这项研究分析了乳酸,PCT,qSOFA,NEWS和综合得分 (NEWS + 乳酸,qSOFA + PCT) 在预测严重CAP的准确性.
主要成果:
- 在预测严重的CAP时,qSOFA + PCT得分显示了最高的准确性 (AUROC = 0.758).
- 单独的qSOFA和PCT也显示出足够的准确性,而血液中的乳酸盐水平并不显著.
- NEWS 和 NEWS + 乳酸盐得分显示中度准确性,在严重和轻度的CAP组之间观察到显著差异.
结论:
- qSOFA和PCT的组合是一种非常准确和可靠的方法来检测严重的CAP.
- 这种综合评分方法为在紧急情况下早期识别严重的CAP提供了有希望的工具.
- 在不同的临床环境中,需要进一步验证qSOFA + PCT得分.
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