qSOFA 对疑似感染的急诊科患者死亡率和 ICU 住院时间延长的预测作用。
qSOFA as predictor of mortality and prolonged ICU admission in Emergency Department patients with suspected infection.
机构信息
Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia; Data Analytics Research and Evaluation (DARE) Center, Melbourne University and Austin Hospital, Melbourne, Australia.
Emergency Department, Austin Health, Heidelberg, Melbourne, Victoria, Australia; School of Medicine, The University of Melbourne, Parkville, Melbourne, Victoria, Australia.
出版信息
J Crit Care. 2018 Dec;48:118-123. doi: 10.1016/j.jcrc.2018.08.022. Epub 2018 Aug 21.
PURPOSE
We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection.
PATIENTS AND METHODS
We measured qSOFA in a cohort of 11,205 ED patients with suspected infection. The primary outcome was in-hospital mortality and/or ICU stay ≥3 days.
RESULTS
The qSOFA score was positive in 2429 (21.7%) patients. In-hospital mortality, and in-hospital mortality or ICU stay ≥3 days were 12.8% and 17.2% respectively for qSOFA positive patients vs 2.2% and 4.2% for qSOFA negative patients (p < .0001). For the prediction of in-hospital mortality, a positive qSOFA had a positive predictive value (PPV) of 13% (95% CI, 11-14) and a negative predictive value (NPV) of 98% (95% CI, 97-98). For the prediction of in-hospital mortality or ICU stay ≥3 days, the PPV and NPV of a positive qSOFA were 17% (95% CI, 16-19) and 96 (95% CI, 95-96), respectively.
CONCLUSION
Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.
目的
我们评估了快速序贯器官衰竭评估（qSOFA）评分作为急诊科（ED）疑似感染患者住院死亡率或 ICU 住院时间延长的预测指标。
患者和方法
我们对 11205 例疑似感染的 ED 患者进行了 qSOFA 评分。主要结局为住院死亡率和/或 ICU 住院时间≥3 天。
结果
qSOFA 评分阳性的患者有 2429 例（21.7%）。qSOFA 阳性患者的住院死亡率和住院死亡率或 ICU 住院时间≥3 天分别为 12.8%和 17.2%，qSOFA 阴性患者分别为 2.2%和 4.2%（p<0.0001）。对于住院死亡率的预测，qSOFA 阳性的阳性预测值（PPV）为 13%（95%CI，11-14），阴性预测值（NPV）为 98%（95%CI，97-98）。对于住院死亡率或 ICU 住院时间≥3 天的预测，qSOFA 阳性的 PPV 和 NPV 分别为 17%（95%CI，16-19）和 96%（95%CI，95-96）。
结论
在 ED 疑似感染患者中，qSOFA 阳性患者的死亡率和 ICU 住院时间延长风险显著增加。
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