文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期，新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

对接受血液透析的日本患者进行死亡率和菌血症风险评估的快速序贯器官衰竭评估评分的外部验证：一项回顾性多中心队列研究。

External validation of the quick Sequential Organ Failure Assessment score for mortality and bacteraemia risk evaluation in Japanese patients undergoing haemodialysis: a retrospective multicentre cohort study.

机构信息

Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.

Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan.

出版信息

BMJ Open. 2019 Jul 11;9(7):e028856. doi: 10.1136/bmjopen-2018-028856.

DOI:10.1136/bmjopen-2018-028856
PMID:31300504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6629386/
Abstract

OBJECTIVES: We aimed to examine the validity of the quick Sequential Organ Failure Assessment (qSOFA) score for mortality and bacteraemia risk assessment in Japanese haemodialysis patients. DESIGN: This is a retrospective multicentre cohort study. SETTING: The six participating hospitals are tertiary-care institutions that receive patients on an emergency basis and provide primary, secondary and tertiary care. The other participating hospital is a secondary-care institution that receives patients on an emergency basis and provides both primary and secondary care. PARTICIPANTS: This study included haemodialysis outpatients admitted for bacteraemia suspicion, who had blood drawn for cultures within 48 hours of their initial admission. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was overall in-hospital mortality. Secondary outcomes included 28-day in-hospital mortality and the incidence of bacteraemia diagnosed based on blood culture findings. The discrimination, calibration and test performance of the qSOFA score were assessed. Missing data were handled using multiple imputation. RESULTS: Among the 507 haemodialysis patients admitted with bacteraemia suspicion between August 2011 and July 2013, the overall in-hospital mortality was 14.6% (74/507), the 28-day in-hospital mortality was 11.1% (56/507) and the incidence of bacteraemia, defined as a positive blood culture, was 13.4% (68/507). For predicting in-hospital mortality among haemodialysis patients, the area under the receiver operating characteristic curve was 0.61 (95% CI 0.56-0.67) for a qSOFA score ≥2. The Hosmer-Lemeshow χ statistics for the qSOFA score as a predictor of overall and 28-day in-hospital mortality were 5.72 (p=0.02) and 7.40 (p<0.01), respectively. CONCLUSION: On external validation, the qSOFA score exhibited low diagnostic accuracy and miscalibration for in-hospital mortality and bacteraemia among haemodialysis patients.

摘要

目的：本研究旨在检验快速序贯器官衰竭评估（qSOFA）评分对日本血液透析患者死亡和菌血症风险评估的有效性。

设计：这是一项回顾性多中心队列研究。

地点：参与研究的六家医院均为三级医疗机构，可接收急症患者并提供初级、二级和三级护理。另一家参与研究的医院为二级医疗机构，也可接收急症患者并提供初级和二级护理。

参与者：本研究纳入了因疑似菌血症而入院的血液透析门诊患者，这些患者在入院后 48 小时内接受了血液培养。

主要和次要结局指标：主要结局指标为全因院内死亡率。次要结局指标包括 28 天院内死亡率和基于血培养结果诊断的菌血症发生率。评估了 qSOFA 评分的区分度、校准度和检验效能。使用多重插补法处理缺失数据。

结果：在 2011 年 8 月至 2013 年 7 月期间，因疑似菌血症而入院的 507 例血液透析患者中，总的院内死亡率为 14.6%（74/507），28 天院内死亡率为 11.1%（56/507），血培养阳性定义的菌血症发生率为 13.4%（68/507）。对于预测血液透析患者的院内死亡率，qSOFA 评分≥2 分的受试者工作特征曲线下面积为 0.61（95%CI 0.56-0.67）。qSOFA 评分预测全因和 28 天院内死亡率的 Hosmer-Lemeshow χ 检验统计量分别为 5.72（p=0.02）和 7.40（p<0.01）。

结论：在外部验证中，qSOFA 评分对血液透析患者的院内死亡率和菌血症的诊断准确性较低，且校准度不佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9442/6629386/d18fce51ad54/bmjopen-2018-028856f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9442/6629386/d18fce51ad54/bmjopen-2018-028856f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9442/6629386/d18fce51ad54/bmjopen-2018-028856f01.jpg

相似文献

[1]
External validation of the quick Sequential Organ Failure Assessment score for mortality and bacteraemia risk evaluation in Japanese patients undergoing haemodialysis: a retrospective multicentre cohort study.

BMJ Open. 2019-7-11

[2]
Use of prehospital qSOFA in predicting in-hospital mortality in patients with suspected infection: A retrospective cohort study.

PLoS One. 2019-5-7

[3]
Superior performance of National Early Warning Score compared with quick Sepsis-related Organ Failure Assessment Score in predicting adverse outcomes: a retrospective observational study of patients in the prehospital setting.

Eur J Emerg Med. 2019-12

[4]
Evaluation of qSOFA as a Predictor of Mortality Among ICU Patients With Positive Clinical Cultures-A Retrospective Cohort Study.

J Intensive Care Med. 2020-11

[5]
Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit.

JAMA. 2017-1-17

[6]
Early variation of quick sequential organ failure assessment score to predict in-hospital mortality in emergency department patients with suspected infection.

Eur J Emerg Med. 2019-8

[7]
Predictors of mortality of bloodstream infections among internal medicine patients in a Swiss Hospital: Role of quick Sequential Organ Failure Assessment.

Eur J Intern Med. 2019-5-23

[8]
Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit.

Crit Care. 2017-3-26

[9]
Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

JAMA. 2016-2-23

[10]
Low Accuracy of Positive qSOFA Criteria for Predicting 28-Day Mortality in Critically Ill Septic Patients During the Early Period After Emergency Department Presentation.

Ann Emerg Med. 2017-6-29

引用本文的文献

[1]
The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients.

Cureus. 2023-5-30

[2]
Carbapenem-resistant IMP-1-producing Pseudocitrobacter vendiensis emerging in a hemodialysis unit.

Braz J Microbiol. 2022-3

[3]
Added value of clinical prediction rules for bacteremia in hemodialysis patients: An external validation study.

PLoS One. 2021

本文引用的文献

[1]
Low Accuracy of Positive qSOFA Criteria for Predicting 28-Day Mortality in Critically Ill Septic Patients During the Early Period After Emergency Department Presentation.

Ann Emerg Med. 2017-6-29

[2]
qSOFA Has Poor Sensitivity for Prehospital Identification of Severe Sepsis and Septic Shock.

Prehosp Emerg Care. 2017

[3]
Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department.

JAMA. 2017-1-17

[4]
Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection.

Ann Emerg Med. 2017-4

[5]
Development and Validation of a Clinical Prediction Rule for Bacteremia among Maintenance Hemodialysis Patients in Outpatient Settings.

PLoS One. 2017-1-12

[6]
Systemic Inflammatory Response Syndrome Is Not an Indicator of Bacteremia in Hemodialysis Patients With Native Accesses: A Multicenter Study.

ASAIO J. 2017

[7]
Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection.

Chest. 2017-3

[8]
Sepsis Clinical Criteria in Emergency Department Patients Admitted to an Intensive Care Unit: An External Validation Study of Quick Sequential Organ Failure Assessment.

J Emerg Med. 2017-5

[9]
Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit.

Am J Respir Crit Care Med. 2017-4-1

[10]
Predictive performance of quick Sepsis-related Organ Failure Assessment for mortality and ICU admission in patients with infection at the ED.

Am J Emerg Med. 2016-9

文献AI研究员

20分钟写一篇综述，助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索