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快速脓毒症相关器官功能衰竭评估评分作为感染性心内膜炎院内不良事件的潜在预测指标。

Quick sepsis-related organ failure assessment score as a possible predictor for in-hospital adverse events in infective endocarditis.

作者信息

Tamura Yudai, Nomura Akihiro, Yoshida Shohei, Tada Hayato, Sakata Kenji, Iino Kenji, Furusho Hiroshi, Takamura Masayuki, Takemura Hirofumi, Yamagishi Masakazu, Kawashiri Masa-Aki

机构信息

Division of Cardiology Kanazawa University Hospital Kanazawa Japan.

Department of Cardiovascular and Internal Medicine Kanazawa University Graduate School of Medicine Kanazawa Japan.

出版信息

Acute Med Surg. 2019 Feb 19;6(2):138-144. doi: 10.1002/ams2.393. eCollection 2019 Apr.

Abstract

AIM

Infective endocarditis (IE) can be life-threatening because of various associated adverse events. The quick Sepsis-related Organ Failure Assessment (qSOFA) score is a straightforward useful method for predicting in-hospital mortality in patients with suspected infections. However, few data exist regarding the clinical impact of the qSOFA score on predicting adverse events in IE during hospitalization. We studied the usefulness of qSOFA score for predicting in-hospital adverse events in patients with IE.

METHODS

We retrospectively analyzed 104 consecutive patients diagnosed with IE on the basis of modified Duke criteria. We defined in-hospital adverse events as occurrence of any of the following events during hospitalization: death, embolism, hemorrhage, or abscess formation. The high qSOFA group was defined as those with a qSOFA score ≥2. We used Cox regression analysis to estimate the hazard ratio for high qSOFA score on in-hospital adverse events adjusted for age, sex, and infection.

RESULTS

We analyzed 83 patients (57 men, mean age 61 ± 18 years) from the total cohort of 104 patients enrolled. Among these, 12 (14.5%) had high qSOFA scores. The high qSOFA group had higher in-hospital mortality compared to the low qSOFA group (50.0% vs. 4.2%,  < 0.01). In the Cox proportional hazards model, high qSOFA was significantly associated with in-hospital adverse events (adjusted hazard ratio, 2.29; confidence interval, 1.02-5.12;  = 0.044).

CONCLUSION

These results showed that high qSOFA score was significantly associated with in-hospital adverse events in IE patients, although further prospective study is necessary to confirm our results.

摘要

目的

感染性心内膜炎(IE)由于各种相关不良事件可能危及生命。快速脓毒症相关器官功能衰竭评估(qSOFA)评分是预测疑似感染患者院内死亡率的一种简单有用的方法。然而,关于qSOFA评分对预测IE患者住院期间不良事件的临床影响的数据较少。我们研究了qSOFA评分对预测IE患者院内不良事件的有用性。

方法

我们回顾性分析了104例根据改良杜克标准确诊为IE的连续患者。我们将院内不良事件定义为住院期间发生以下任何一种事件:死亡、栓塞、出血或脓肿形成。高qSOFA组定义为qSOFA评分≥2的患者。我们使用Cox回归分析来估计高qSOFA评分对经年龄、性别和感染调整后的院内不良事件的风险比。

结果

我们分析了当纳入的104例患者总数中的83例患者(57例男性,平均年龄61±18岁)。其中,12例(14.5%)qSOFA评分高。与低qSOFA组相比,高qSOFA组的院内死亡率更高(50.0%对4.2%,<0.01)。在Cox比例风险模型中,高qSOFA与院内不良事件显著相关(调整后的风险比为2.29;置信区间为1.02 - 5.12;=0.044)。

结论

这些结果表明,高qSOFA评分与IE患者的院内不良事件显著相关,尽管需要进一步的前瞻性研究来证实我们的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dce/6442521/a381c8d1a4ff/AMS2-6-138-g001.jpg

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