全身炎症反应综合征与快速序贯器官衰竭评估评分在急诊科预测菌血症中的比较。
Comparison of Systemic Inflammatory Response Syndrome and quick Sequential Organ Failure Assessment scores in predicting bacteremia in the emergency department.
作者信息
Furuta Katsuyuki, Akamatsu Hiroaki, Sada Ryuichi, Miyamoto Kyohei, Teraoka Shunsuke, Hayata Atsushi, Ozawa Yuichi, Nakanishi Masanori, Koh Yasuhiro, Yamamoto Nobuyuki
机构信息
Internal Medicine III Wakayama Medical University Wakayama Japan.
Department of General Internal Medicine Tenri Hospital Tenri Japan.
出版信息
Acute Med Surg. 2021 May 1;8(1):e654. doi: 10.1002/ams2.654. eCollection 2021 Jan-Dec.
AIM
The emergency department requires simple and useful clinical indicators to identify bacteremia. This retrospective study explored the Systemic Inflammatory Response Syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) scores for predicting bacteremia.
METHODS
Between April and September 2017, we assessed blood cultures of 307 patients in our emergency department. We calculated the SIRS and qSOFA scores for these patients and evaluated their correlation with bacteremia.
RESULTS
Of 307 patients, 66 (21.5%) had bacteremia, 237 (77.2%) were SIRS-positive, and 123 (40.0%) were qSOFA-positive. The sensitivity and specificity of the SIRS score for predicting bacteremia were 87.9% and 25.7%, respectively. The sensitivity and specificity of the qSOFA score were 47.0% and 61.8%, respectively. Multivariate analysis revealed that body temperature (odds ratio, 2.16; 95% confidence interval, 1.22-3.84; = 0.009) and blood pressure (odds ratio, 2.72; 95% confidence interval, 1.39-5.35; = 0.004) significantly associated with bacteremia.
CONCLUSIONS
The SIRS score was a more sensitive indicator than the qSOFA score for predicting bacteremia.
目的
急诊科需要简单且实用的临床指标来识别菌血症。本回顾性研究探讨了全身炎症反应综合征（SIRS）和快速序贯器官衰竭评估（qSOFA）评分对菌血症的预测价值。
方法
2017年4月至9月期间，我们对急诊科的307例患者的血培养结果进行了评估。我们计算了这些患者的SIRS和qSOFA评分，并评估了它们与菌血症的相关性。
结果
307例患者中，66例（21.5%）发生菌血症，237例（77.2%）SIRS阳性，123例（40.0%）qSOFA阳性。SIRS评分预测菌血症的敏感性和特异性分别为87.9%和25.7%。qSOFA评分的敏感性和特异性分别为47.0%和61.8%。多因素分析显示，体温（比值比，2.16；95%置信区间，1.22 - 3.84；P = 0.009）和血压（比值比，2.72；95%置信区间，1.39 - 5.35；P = 0.004）与菌血症显著相关。
结论
在预测菌血症方面，SIRS评分比qSOFA评分更敏感。
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