使用急性肾损伤分类对序贯性器官衰竭评估评分进行修正。
Modification of sequential organ failure assessment score using acute kidney injury classification.
机构信息
Department of Critical Care Medicine, Japanese Red Cross Society Wakayama Medical Center, 4-20, Komatsubara-dori, Wakayama, Japan; Department of Intensive Care Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Japan.
Department of Epidemiology and Preventive Medicine, Kyoto University Graduate School of Medicine, Yoshida Hon-machi, Sakyo-ku, Kyoto, Japan; Japan Society for the Promotion of Science. 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, Japan.
出版信息
J Crit Care. 2019 Jun;51:198-203. doi: 10.1016/j.jcrc.2019.02.026. Epub 2019 Feb 26.
PURPOSE
To assess the predictive validity of a modified Sequential Organ Failure Assessment (SOFA) score, of which the renal component was replaced with Kidney Disease Improving Global Outcomes (KDIGO) classification of Acute Kidney Injury (AKI).
MATERIALS AND METHODS
Using a prospective cohort study on AKI in Japan, we replaced the renal component of SOFA score with AKI stages according to the KDIGO criteria except that initiation of renal replacement therapy was assigned four points. We assessed the predictive validity of KDIGO-based SOFA score for hospital and ICU mortality by comparing the areas under the receiver operating characteristic curve (AUC) derived from logistic regression models with that of the original SOFA score.
RESULTS
2292 patients were registered. Overall hospital mortality was 11.6%, and ICU mortality was 5.1%. KDIGO-based SOFA score was moderately correlated with APACHE II score (rho = 0.476). The AUC for hospital and ICU mortality of KDIGO-based and the original SOFA score were 0.749 vs 0.745 (p = .393) and 0.790 vs 0.791 (p = .900).
CONCLUSIONS
The prognostic performance of KDIGO-based SOFA score was not superior but comparable to that of the original SOFA score.
目的
评估改良的序贯器官衰竭评估（SOFA）评分的预测效度，该评分的肾脏部分被肾脏病改善全球结局组织（KDIGO）急性肾损伤（AKI）分类取代。
材料与方法
我们使用日本 AKI 的前瞻性队列研究，将 SOFA 评分的肾脏部分用 KDIGO 标准的 AKI 分期取代，除了开始肾脏替代治疗被赋值 4 分外。我们通过比较基于 KDIGO 的 SOFA 评分和原始 SOFA 评分的逻辑回归模型得出的受试者工作特征曲线（ROC）下面积（AUC），来评估基于 KDIGO 的 SOFA 评分对住院和 ICU 死亡率的预测效度。
结果
共登记了 2292 例患者。总体住院死亡率为 11.6%，ICU 死亡率为 5.1%。基于 KDIGO 的 SOFA 评分与急性生理与慢性健康状况评分系统 II（APACHE II）评分中度相关（rho=0.476）。基于 KDIGO 的 SOFA 评分和原始 SOFA 评分的住院和 ICU 死亡率的 AUC 分别为 0.749 比 0.745（p=0.393）和 0.790 比 0.791（p=0.900）。
结论
基于 KDIGO 的 SOFA 评分的预后性能并不优于但可与原始 SOFA 评分相媲美。
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