在儿科败血症休克中对修改的儿科败血症诱导凝血病评分的评估
Chenhao Wang1, Bian Jin2, Fang Fang1
1Department of Critical Care Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing 400014, China.
Thrombosis research
|July 16, 2025
概括
一个新的儿科败血症诱导凝血病 (pSIC) 评分,基于星败血症评分 (PSS),有效地识别高风险儿童,并预测败血症患者的死亡率. 该工具有助于根据新的败血症标准评估凝血病.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液学和血栓形成
- 传染病 传染病 传染病
背景情况:
- 败血症引起的凝血病 (SIC) 是败血症的常见并发症,影响患者的治疗结果.
- 根据当前 (2024) 败血症标准,儿童SIC缺乏经过验证的评估工具.
- 早期识别和管理SIC对于改善儿科败血症护理至关重要.
研究的目的:
- 开发和验证一个修改的儿科SIC (pSIC) 评分,使用星败血症评分 (PSS).
- 评估修改后的PSIC得分在患有败血症休克的儿童中的诊断和预后效用.
- 评估得分能够预测死亡率和公开传播的血管内凝血 (DIC) 的能力.
主要方法:
- 对432名患有败血症休克的儿科患者进行了回顾性研究.
- 通过将顺序性器官衰竭评估 (SOFA) 评分替换为PSS,开发修改后的PSIC评分.
- 分析基线特征,不良结果,28天死亡率和明显的DIC.
主要成果:
- 升高的修改后PSIC分数与更差的基线特征和不良结果风险增加相关.
- 与现有得分相比,修改后的PSIC得分显示了28天死亡率的优异预测值.
- 该得分显示出良好的预测能力和对明显的DIC的高灵敏度,高PSIC组的死亡率明显较高 (38.2%对12.8%).
结论:
- 根据更新的败血症标准,修改后的PSIC得分显示出作为儿科SIC诊断和预后工具的前景.
- 这一得分在儿科败血症休克患者的单中心队列中显示出良好的效用.
- 进一步验证不同的儿科败血症群体是有必要的,以确认其更广泛的适用性.
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