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不同评分系统的预后准确性,用于评估血症中的凝血病:一项回顾性研究
Yuwei Chen1,2, Weiwei Chen1, Fuhua Ba1
1Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
概括
败血症引起的凝血病 (SIC) 和ISTH公开的DIC得分有效预测死亡率,但SIC提供了更优质的校准. 在败血症患者中,JAAM DIC与死亡率没有显著的关联.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 败血症研究 败血症研究
背景情况:
- 败血症中的凝血功能障碍缺乏明确的诊断标准.
- 目前对于败血症引起的凝血病 (SIC) 的评分系统仍然存在争议.
- 准确的预后工具对于治疗败血症患者至关重要.
研究的目的:
- 为了评估SIC,JAAM DIC和ISTH公开DIC评分系统的诊断性能.
- 评估这些评分系统与败血症28天全因死亡率之间的关联.
- 确定最合适的评分系统来诊断败血症中的凝血病.
主要方法:
- 对452名败血症患者的回顾性分析.
- 对诊断准确度 (AUROC) 和SIC,JAAM DIC和ISTH公开DIC的校准进行比较.
- 检查评分系统与28天全因死亡率之间的关系.
主要成果:
- 无论是SIC还是ISTH的公开DIC,都在28天死亡率方面表现出类似的歧视 (AUROC:分别为0.779和0.782).
- 与ISTH公开DIC相比,SIC在预测28天死亡率方面显示出优异的校准.
- JAAM DIC与28天全因死亡率没有独立相关 (RR: 1.115).
结论:
- SIC评分系统在败血症中表现出卓越的预后预测能力.
- 建议SIC作为诊断败血症凝血病的最合适的标准.
- 需要进一步验证SIC在不同毒症群体中的有效性.
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