急诊科用于预测严重脓毒症和脓毒性休克患者死亡率的MISSED评分的外部验证
External validation of the MISSED score to predict mortality in patients with severe sepsis and septic shock in the emergency department.
作者信息
Ryoo Seung Mok, Ahn Shin, Kim Won Young, Lim Kyoung Soo
机构信息
Department of Emergency Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
出版信息
Eur J Emerg Med. 2015 Oct;22(5):327-30. doi: 10.1097/MEJ.0000000000000156.
OBJECTIVE
The Mortality in Severe Sepsis in the Emergency Department (MISSED) score was derived to predict in-hospital mortality in septic patients in the emergency department (ED). The present study aimed to validate the MISSED score in patients receiving early goal-directed therapy (EGDT).
METHODS
Data were analyzed from 280 patients who received EGDT in a tertiary center ED in Korea. Age 65 years and above, albumin level 27 g/l or less, and international normalized ratio of at least 1.2 were variables included in the MISSED score.
RESULTS
With a cutoff point of 5.5, the odds ratio for death was 2.17 (95% confidence interval 1.18-4.02). Mortality rates with MISSED scores of 0,< 5.5, and ≥ 5.5 were 4.5, 13.4, and 25.2%, respectively. Although the score was less discriminatory in patients who had EGDT commenced in the ED, a MISSED score higher than 5.5 remained significant.
CONCLUSION
Further studies are required to validate the MISSED score in more diverse patients.
目的
推导急诊科严重脓毒症死亡率（MISSED）评分，以预测急诊科脓毒症患者的院内死亡率。本研究旨在验证早期目标导向治疗（EGDT）患者的MISSED评分。
方法
分析韩国一家三级中心急诊科280例接受EGDT患者的数据。年龄65岁及以上、白蛋白水平27g/L及以下、国际标准化比值至少为1.2是MISSED评分中的变量。
结果
截断值为5.5时，死亡比值比为2.17（95%置信区间1.18 - 4.02）。MISSED评分为0、<5.5和≥5.5时的死亡率分别为4.5%、13.4%和25.2%。尽管该评分在急诊科开始接受EGDT的患者中鉴别能力较低，但MISSED评分高于5.5仍具有显著性。
结论
需要进一步研究以在更多样化的患者中验证MISSED评分。
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