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[早期使用脓毒症评分预测非ICU新冠肺炎患者的呼吸衰竭和死亡率]

[The early use of sepsis scores to predict respiratory failure and mortality in non-ICU patients with COVID-19].

作者信息

Lalueza A, Lora-Tamayo J, de la Calle C, Sayas-Catalán J, Arrieta E, Maestro G, Mancheño-Losa M, Marchán-López Á, Díaz-Simón R, García-García R, Catalán M, García-Reyne A, de Miguel-Campo B, Lumbreras C

机构信息

Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España.

Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.

出版信息

Rev Clin Esp. 2022 May;222(5):293-298. doi: 10.1016/j.rce.2020.10.004. Epub 2020 Nov 7.

DOI:10.1016/j.rce.2020.10.004
PMID:33191944
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7648653/
Abstract

This observational retrospective study aimed to investigate the usefulness of Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), National Early Warning Score (NEWS), and quick NEWS in predicting respiratory failure and death among patients with COVID-19 hospitalized outside of intensive care units (ICU). We included 237 adults hospitalized with COVID-19 who were followed-up on for one month or until death. Respiratory failure was defined as a PaO/FiO ratio ≤ 200 mmHg or the need for mechanical ventilation. Respiratory failure occurred in 77 patients (32.5%), 29 patients (12%) were admitted to the ICU, and 49 patients (20.7%) died. Discrimination of respiratory failure was slightly higher in NEWS, followed by SOFA. Regarding mortality, SOFA was more accurate than the other scores. In conclusion, sepsis scores are useful for predicting respiratory failure and mortality in COVID-19 patients. A NEWS score ≥ 4 was found to be the best cutoff point for predicting respiratory failure.

摘要

这项观察性回顾性研究旨在调查序贯器官衰竭评估（SOFA）、快速SOFA（qSOFA）、国家早期预警评分（NEWS）和快速NEWS在预测非重症监护病房（ICU）住院的COVID-19患者呼吸衰竭和死亡方面的效用。我们纳入了237名因COVID-19住院的成年人，对他们进行了为期一个月的随访或直至死亡。呼吸衰竭定义为动脉血氧分压/吸入氧分数值（PaO/FiO）≤200 mmHg或需要机械通气。77例患者（32.5%）发生呼吸衰竭，29例患者（12%）入住ICU，49例患者（20.7%）死亡。NEWS对呼吸衰竭的鉴别能力略高于其他指标，其次是SOFA。关于死亡率，SOFA比其他评分更准确。总之，脓毒症评分有助于预测COVID-19患者的呼吸衰竭和死亡率。发现NEWS评分≥4是预测呼吸衰竭的最佳临界点。

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