快速序列器官衰竭评估 (qSOFA) 和性能状态评分系统作为肺炎球菌社区获得性肺炎的预后预测器
Shuichi Abe1, Dhammika Leshan Wannigama1
1Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, JPN.
Cureus
|December 9, 2024
概括
预测pneumococcal社区获得性肺炎 (pCAP) 的死亡率至关重要. 快速序列器官衰竭评估 (qSOFA) 评分和性能状态 (PS) 独立预测pCAP患者的60天死亡率.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
背景情况:
- 由*Streptococcus pneumoniae*引起的肺炎球菌社区获得性肺炎 (pCAP) 是严重疾病,败血症和死亡的重要原因.
- 准确评估PCAP严重程度对于及时干预和改善患者结果至关重要.
- 现有的临床评分系统,如A-DROP,CURB-65和qSOFA,用于评估CAP和败血症的严重程度.
研究的目的:
- 确定预测肺炎球菌社区获得性肺炎 (pCAP) 诊断的患者60天死亡率的临床因素.
- 评估已建立的严重性评分系统 (A-DROP,CURB-65,qSOFA) 和绩效状态 (PS) 在预测PCAP死亡率方面的有用性.
主要方法:
- 一项回顾性研究涉及192名患者 (≥16岁) 在2012年1月至2018年5月期间被诊断患有PCAP在日本山口县中央医院.
- 根据60天死亡率,患者被分为幸存者和非幸存者.
- 临床参数,包括绩效状态 (PS),A-DROP,CURB-65和qSOFA分数,被评估和组之间的比较.
主要成果:
- 与幸存者相比,未幸存者在血液培养物中检测到的*S.肺炎*的发病率更高 (27.3%与7.7%相比),并且表现出明显较差的表现状态 (PS ≥3),更高的A-DROP得分 (A-DROP ≥3) 和更高的qSOFA得分 (qSOFA ≥2).
- 多变量分析确定了较高的qSOFA得分 (OR 4.0) 和低绩效状态 (PS ≥3) (OR 4.0) 作为pCAP中60天死亡率的独立预测因素.
- 在CURB-65评分中,幸存者与非幸存者之间没有显著差异.
结论:
- 快速序列器官衰竭评估 (qSOFA) 评分和性能状态 (PS) 是预测肺炎球菌社区性肺炎 (pCAP) 预后的宝贵工具.
- 这些评分系统可以帮助临床医生识别高风险的PCAP患者,这些患者可能需要更密集的管理.
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