发展和验证儿童败血症和败血性休克的标准
L Nelson Sanchez-Pinto1, Tellen D Bennett2, Peter E DeWitt3
1Departments of Pediatrics (Critical Care) and Preventive Medicine (Health and Biomedical Informatics), Northwestern University Feinberg School of Medicine, and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
JAMA
|January 21, 2024
概括
儿童败血症和败血性休克的新标准,即败血症评分,在各种医疗机构中证明了诊断儿童严重疾病的准确性.
科学领域:
- 危急护理医学
- 儿童传染病
- 临床诊断
背景情况:
- 儿童败血症诊断依赖于需要在不同环境中验证的标准.
- 现有的标准可能无法准确地识别儿童的败血症和败血性休克.
研究的目的:
- 开发和验证儿童败血症和败血性休克的新临床标准.
- 通过器官功能障碍的测量来建立数据驱动的标准.
- 确保标准在资源丰富和资源有限的环境中发挥作用.
主要方法:
- 一个多中心的国际回顾性队列研究,涉及300多万名儿童 (2010-2019).
- 使用堆叠回归模型预测疑似感染儿童的死亡率.
- 最终的模型被转化为基于整数的评分 (Phoenix 败血症评分),以定义败血症和败血症冲击标准.
主要成果:
- 一个四个器官系统的模型,菲尼克斯败血症评分,显示出强大的死亡预测性能.
- 与2005年国际儿科败血症共识会议 (IPSCC) 标准相比,Phoenix败血症得分显示出更好的预测值和敏感性.
- 在多个国际医疗环境中验证了该项目的性能.
结论:
- 新败血症标准为儿童败血症和败血症休克提供了更好的诊断准确性.
- 这些标准已被验证用于高资源和低资源环境.
- 菲尼克斯败血症评分代表了儿童败血症全球诊断的重大进展.
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