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病毒流行率、临床特征及严重度评分对预测成人严重急性呼吸道感染患者死亡率的比较。

Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections.

机构信息

Department of Emergency Medicine, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey

出版信息

Turk J Med Sci. 2019 Jun 18;49(3):862-871. doi: 10.3906/sag-1807-231.

Abstract

BACKGROUND/AIM: The aim of this study was to determine the accuracy of severity scores for predicting the 28-day mortality among adults with severe acute respiratory infection (SARI) admitted to the emergency department.

MATERIALS AND METHODS

This study included 159 consecutive adult patients with SARI admitted to the emergency department of a tertiary hospital. A standard form was filled out in order to record demographic information, clinical parameters, laboratory tests, and radiographic findings of the patients. CURB-65, PSI, SIRS, qSOFA, SOFA and APACHE II scores were compared between the survivor and nonsurvivor groups.

RESULTS

Of 159 patients included in the study, 38.4% were positive for respiratory viruses and 28.3% were positive for influenza viruses. 35.8% of the patients were admitted to an intensive care unit (ICU) and the mortality rate was 36.5%. The area under the receiver operating characteristic curve of CURB-65, PSI, SIRS criteria, qSOFA, SOFA and APACHE II scores were 0.717, 0.712, 0.607, 0.683, 0.755, and 0.748, respectively in predicting mortality and 0.759, 0.744, 0.583, 0.728, 0.741, and 0.731, respectively in predicting ICU admission.

CONCLUSION

SOFA and APACHE II were more accurate than SIRS in predicting the 28-day mortality among adults with SARI. There was no significant difference among these scores in terms of other multivariate comparisons.

摘要

背景/目的:本研究旨在确定严重评分系统对预测因严重急性呼吸道感染(SARI)入住急诊科的成年人 28 天死亡率的准确性。

材料和方法

本研究纳入了 159 名连续入住三级医院急诊科的成人 SARI 患者。填写标准表格,记录患者的人口统计学信息、临床参数、实验室检查和影像学结果。比较 CURB-65、PSI、SIRS、qSOFA、SOFA 和 APACHE II 评分在幸存者和非幸存者组之间的差异。

结果

在纳入研究的 159 名患者中,38.4%为呼吸道病毒阳性,28.3%为流感病毒阳性。35.8%的患者入住重症监护病房(ICU),死亡率为 36.5%。CURB-65、PSI、SIRS 标准、qSOFA、SOFA 和 APACHE II 评分预测死亡率的受试者工作特征曲线下面积分别为 0.717、0.712、0.607、0.683、0.755 和 0.748,预测 ICU 入住的面积分别为 0.759、0.744、0.583、0.728、0.741 和 0.731。

结论

SOFA 和 APACHE II 比 SIRS 更能准确预测 SARI 成人 28 天死亡率。在其他多变量比较中,这些评分之间没有显著差异。

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