六个评分系统的预后价值在预测败血症患者的24小时死亡率
M Djikic1, M Milenkovic, M Stojadinovic
1Emergency Center, University Clinical Center of Serbia, Belgrade, Serbia. marija.milenkovic@med.bg.ac.rs.
概括
序列器官衰竭评估 (SOFA) 评分,增强了乳酸水平,有效预测急诊室败血症患者的24小时死亡率. 这种组合为早期风险分层提供了可靠的工具.
科学领域:
- 紧急医疗 紧急医疗
- 关键护理医学 关键护理医学
- 临床预后 临床预后
背景情况:
- 败血症患者的鉴定和风险分层对于及时干预至关重要.
- 对于败血症预后的现有评分系统的有效性各不相同.
- 对败血症患者的最佳预测工具的搜索仍在继续.
研究的目的:
- 评估六个评分系统在预测急诊室败血症患者24小时死亡率方面的预后价值.
- 为了确定早期败血症死亡率预测最有效的评分系统.
- 评估添加乳酸盐以提高预测准确性的影响.
主要方法:
- 一项涉及连续性败血症患者 (败血症-3定义) 在急诊室的观察性回顾性研究.
- 分析了六个评分系统:SOFA,qSOFA,SIRS,NEWS,SPEED和MEDS. 这六个评分系统的分析.
- 接收器操作特征 (ROC) 分析以确定24小时死亡率的预测值,随后将乳酸添加到表现最佳的得分.
主要成果:
- 顺序性器官衰竭评估 (SOFA) 评分显示,24小时死亡率的预测值最高 (AUC 0.755),尽管效果适度.
- 添加乳酸盐显著提高了SOFA对24小时死亡率的预测准确性 (AUC0.865,p=0.0081).
- 其他分数如SPEED,MEDS和NEWS具有适度的预测能力,而SIRS和qSOFA对24小时死亡率无关紧要.
结论:
- 加上乳酸盐测量,SOFA评分作为一个强大的工具,用于在急诊室的败血症患者早期风险分层.
- 这种综合方法改善了危急性败血症患者的短期死亡率的预测.
- 需要在各种紧急情况下对SOFA-乳酸盐组合进行进一步验证.
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