中毒严重程度评分和序贯性器官衰竭评估评分：一氧化碳中毒预后。
Poison severity score and sequential organ failure assessment score: Carbon monoxide poisoning prognosis.
机构信息
Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Department of Emergency Medicine, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Yangsan, South Korea.
出版信息
PLoS One. 2019 Mar 1;14(3):e0212025. doi: 10.1371/journal.pone.0212025. eCollection 2019.
PURPOSE
We aimed to examine the utility of the Poison Severity Score (PSS) and Sequential Organ Failure Assessment (SOFA) score as early prognostic predictors of short-term outcomes in patients with carbon monoxide (CO) poisoning. We hypothesized that both the PSS and the SOFA score would be useful prognostic tools.
METHODS
This was retrospective observational study of patients with CO poisoning who presented to the emergency department and were admitted for more than 24 hours. We calculated PSS, the initial SOFA score, a second (2nd) SOFA score, and a 24-hour delta SOFA score. The primary outcome was reported as the cerebral performance category (CPC) scale score at discharge. We classified those with CPC 1-2 as the good outcome group and those with CPC 3-5 as the poor outcome group.
RESULTS
This study included 192 patients: 174 (90.6%) belonged to the good outcome group, whereas 18 (9.4%) belonged to the poor outcome group. The PSS (1.00 [0.00, 1.00] vs 3.00 [3.00, 3.00], p < 0.001), initial SOFA (1.00 [0.00, 2.00] vs 4.00 [3.25, 6.00], p < 0.001), 2nd SOFA score (0.00 [0.00, 1.00] vs 4.00 [3.00, 7.00], p < 0.001), and 24-hour delta SOFA score (-1.00 [-1.00, 0.00] vs 0.00 [-1.00, 1.00], p = 0.047) of the good outcome group were significantly higher than those of the poor outcome group. The areas under the receiver operating characteristic curve for PSS and the initial SOFA and 2nd SOFA scores were 0.977 (95% confidence interval [CI] 0.944-0.993), 0.945 (95% CI 0.903-0.973), and 0.978 (95% CI 0.947-0.994), respectively.
CONCLUSION
The PSS, initial SOFA score, and 2nd SOFA score predict acute poor outcome accurately in patients with CO poisoning.
目的
我们旨在探讨中毒严重程度评分（PSS）和序贯器官衰竭评估（SOFA）评分作为一氧化碳（CO）中毒患者短期预后的早期预测指标的作用。我们假设 PSS 和 SOFA 评分都是有用的预后工具。
方法
这是一项对因 CO 中毒到急诊科就诊并住院超过 24 小时的患者进行的回顾性观察性研究。我们计算了 PSS、初始 SOFA 评分、第 2 个 SOFA 评分和 24 小时 SOFA 评分差值。主要结局为出院时的脑功能状态评分（CPC）。我们将 CPC 1-2 评为预后良好组，CPC 3-5 评为预后不良组。
结果
本研究共纳入 192 例患者：174 例（90.6%）属于预后良好组，18 例（9.4%）属于预后不良组。PSS（1.00[0.00，1.00]比 3.00[3.00，3.00]，p<0.001）、初始 SOFA（1.00[0.00，2.00]比 4.00[3.25，6.00]，p<0.001）、第 2 个 SOFA 评分（0.00[0.00，1.00]比 4.00[3.00，7.00]，p<0.001）和 24 小时 SOFA 评分差值（-1.00[-1.00，0.00]比 0.00[-1.00，1.00]，p=0.047）在预后良好组显著高于预后不良组。PSS、初始 SOFA 和第 2 个 SOFA 评分的受试者工作特征曲线下面积分别为 0.977（95%置信区间[CI]：0.944-0.993）、0.945（95%CI：0.903-0.973）和 0.978（95%CI：0.947-0.994）。
结论
PSS、初始 SOFA 评分和第 2 个 SOFA 评分可准确预测 CO 中毒患者的急性不良预后。
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