Department of Emergency Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul 130-701,Republic of Korea.
Am J Emerg Med. 2012 Feb;30(2):362-6. doi: 10.1016/j.ajem.2010.12.017. Epub 2011 Feb 26.
There is limited literature describing clinical predictors for critically ill patients with cancer who present to the emergency department (ED).
The aim of this study was to investigate the usefulness of the Sequential Organ Failure Assessment (SOFA) score at the time of ED presentation for predicting short-term mortality in patients with advanced cancer.
This was a prospective observational study of 108 consecutive patients with advanced cancer who presented to the ED. The outcome was defined as death within 14 days after admission.
The median survival time of the study subjects was 26.5 days (interquartile range, 9.0-78.0 days), and 31 patients (28.7%) died within 14 days after admission. In univariate analysis, SOFA score (≥4), previous chemotherapy, and altered mental status were predictive of 14-day mortality. Of those variables, only SOFA score was an independent predictor in multivariate analysis.
The use of the SOFA score is an acceptable method for risk stratification and prognosis of patients with advanced cancer in the ED. This score can help clinicians to predict 14-day mortality and plan appropriate treatment for critically ill patients with cancer who present to the ED.
目前关于癌症危重症患者就诊于急诊（ED）时的临床预测因子的文献有限。
本研究旨在探讨 ED 就诊时序贯器官衰竭评估（SOFA）评分对晚期癌症患者短期死亡率的预测价值。
这是一项对 108 例连续就诊于 ED 的晚期癌症患者的前瞻性观察性研究。结局定义为入院后 14 天内死亡。
研究对象的中位生存时间为 26.5 天（四分位间距，9.0-78.0 天），31 例（28.7%）患者在入院后 14 天内死亡。单因素分析显示，SOFA 评分（≥4）、既往化疗和精神状态改变与 14 天死亡率相关。多因素分析中，仅 SOFA 评分是独立的预测因子。
SOFA 评分是 ED 中晚期癌症患者风险分层和预后的一种可行方法。该评分有助于临床医生预测 14 天死亡率，并为就诊于 ED 的癌症危重症患者制定适当的治疗计划。
