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乳酸增强型qSOFA(LqSOFA)评分在预测脓毒症患者的院内死亡率方面优于其他四种快速评分工具。

Lactate-enhanced-qSOFA (LqSOFA) score is superior to the other four rapid scoring tools in predicting in-hospital mortality rate of the sepsis patients.

作者信息

Liu Sijia, He Chengqi, He Weilue, Jiang Tian

机构信息

Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.

Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan, USA.

出版信息

Ann Transl Med. 2020 Aug;8(16):1013. doi: 10.21037/atm-20-5410.

Abstract

BACKGROUND

The rising prevalence of early therapy for sepsis has led to the demand for rapid risk-stratification tools that can estimate the risk of in-hospital mortality for sepsis patients and the need for intensive care unit (ICU) admission. A robust risk-stratification tool is crucial for in-time sepsis treatment. This study aimed to compare the abilities of five rapid scoring systems, i.e., LqSOFA score, qSOFA score, SIRS, MEDS, and MEWS, in predicting the mortality in hospital and ICU admission for sepsis patients.

METHODS

A retrospective observational clinical study was conducted in West China Hospital. Our cases included all patients admitted to the hospital with a diagnosis of sepsis (sepsis-3). We calculated five rapid prediction scores for the enrolled cases. We then compared each rapid score's ability to predict in-hospital mortality and ICU admission.

RESULTS

A total of 821 of mixed sepsis patients by sepsis-3 definition were included. The all-cause hospital mortality rate was 21.1%. The LqSOFA score presented the most significant discrimination with an area under the receiver operating characteristic curve (AUC) of 0.751. The AUC of the LqSOFA score for mortality in the hospital was significantly higher than qSOFA (AUC 0.717), SIRS (AUC 0.704), MEDS (AUC 0.670), and MEWS (AUC 0.685).

CONCLUSIONS

LqSOFA is a superior prognostic tool for predicting mortality in the hospital. It may provide more exact information for hospital mortality than the other 4 rapid scores in treating sepsis patients.

摘要

背景

脓毒症早期治疗的日益普及引发了对快速风险分层工具的需求,这些工具能够估计脓毒症患者的院内死亡风险以及重症监护病房(ICU)收治的必要性。强大的风险分层工具对于及时进行脓毒症治疗至关重要。本研究旨在比较五种快速评分系统,即序贯器官衰竭评估(LqSOFA)评分、快速序贯器官衰竭评估(qSOFA)评分、全身炎症反应综合征(SIRS)、多器官功能障碍评分(MEDS)和改良早期预警评分(MEWS),在预测脓毒症患者院内死亡率和ICU收治情况方面的能力。

方法

在华西医院进行了一项回顾性观察性临床研究。我们的病例包括所有入院诊断为脓毒症(脓毒症-3)的患者。我们为纳入的病例计算了五种快速预测评分。然后比较了每种快速评分预测院内死亡率和ICU收治情况的能力。

结果

根据脓毒症-3定义,共纳入821例混合性脓毒症患者。全因院内死亡率为21.1%。LqSOFA评分的区分度最为显著,受试者操作特征曲线(AUC)下面积为0.751。LqSOFA评分预测院内死亡率的AUC显著高于qSOFA(AUC 0.717)、SIRS(AUC 0.704)、MEDS(AUC 0.670)和MEWS(AUC 0.685)。

结论

LqSOFA是预测院内死亡率的一种优越的预后工具。在治疗脓毒症患者时,与其他4种快速评分相比,它可能为院内死亡率提供更准确的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4406/7475464/9008927be3a7/atm-08-16-1013-f1.jpg

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