Steele Lloyd, Hill Stephen
Core Medical Trainee 2, Department of Acute Medicine, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY.
Consultant in Acute Medicine, Department of Acute Medicine, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth.
Br J Hosp Med (Lond). 2019 Aug 2;80(8):C120-C123. doi: 10.12968/hmed.2019.80.8.C120.
Sepsis-3, published in 2016, defined sepsis as 'life-threatening organ dysfunction caused by a dysregulated host response to infection'. Instead of systemic inflammatory response syndrome (SIRS), calculating the Sequential Organ Failure Assessment (SOFA) score was recommended. The complexity of SOFA also led to the introduction of quick SOFA (qSOFA) as a bedside tool. The simultaneous removal of SIRS and introduction of qSOFA belies their significant differences, with SIRS having a high sensitivity but very low specificity, and qSOFA being very specific for a poor outcome, but having a lower sensitivity than SIRS. In the UK, the variables within qSOFA are collected on a regular and repeated basis, along with additional variables, as part of the National Early Warning Score (NEWS). A knowledge of SIRS, qSOFA and NEWS is of value in assessing patients with suspected sepsis, as discussed in this article.
2016年发布的《脓毒症-3》将脓毒症定义为“宿主对感染的反应失调引起的危及生命的器官功能障碍”。推荐使用序贯器官衰竭评估（SOFA）评分来取代全身炎症反应综合征（SIRS）。SOFA的复杂性还促使快速SOFA（qSOFA）作为一种床旁工具被引入。同时摒弃SIRS并引入qSOFA掩盖了它们之间的显著差异，SIRS敏感性高但特异性很低，而qSOFA对不良预后具有很高的特异性，但敏感性低于SIRS。在英国，作为国家早期预警评分（NEWS）一部分，qSOFA中的变量会与其他变量一起定期且重复收集。如本文所讨论的，了解SIRS、qSOFA和NEWS对于评估疑似脓毒症患者具有重要价值。
