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比较 Pitt 快速评分与 quick sofa 评分和 sofa 评分在尿路感染患者严重程度评分中的应用。

Comparison of quick Pitt to quick sofa and sofa scores for scoring of severity for patients with urinary tract infection.

机构信息

Doctor Peset University Hospital, Universitat de València, Avda Gaspar Aguilar n 90, 46017, Valencia, Spain.

Doctor Peset University Hospital, Valencia, Spain.

出版信息

Intern Emerg Med. 2022 Aug;17(5):1321-1326. doi: 10.1007/s11739-022-02927-9. Epub 2022 Jan 19.

Abstract

Quick Pitt (qPitt), which includes temperature, systolic blood pressure, respiratory rate, cardiac arrest, and mental status, is a new prognostic score derived from the Pitt Bacteremia score. The aim of our study is to compare qPitt with quick SOFA (qSOFA) and SOFA for scoring of severity in patients with urinary tract infection (UTI). Prospective observational study of patients diagnosed with UTI. Area under the ROC curve, sensibility, and specificity to predict 30-day mortality were calculated for qPitt, qSOFA and SOFA and compared. 382 UTI cases were analyzed. Thirty-day mortality (18.8% vs. 5.9%, p < 0.001) and longer hospital stay (6 [1-11] vs. 4 [1-7] days, p < 0.001) were associated with qPitt ≥ 2. However, qPitt had a worse performance to predict 30-day mortality compared to qSOFA and SOFA (AUROC 0.692 vs. 0.832 and 0.806, respectively, p = 0.010 and p = 0.041). The sensitivity of qPitt was lower than the sensitivity of qSOFA and SOFA (70.45 vs. 84.09 for both qSOFA and SOFA, p < 0.001), with a specificity lower than qSOFA and similar to SOFA (60.36 vs. 82.25 and 63.61, p < 0.001 and p = 0.742, respectively). Quick Pitt had moderate prognostic accuracy and performed worse than qSOFA and SOFA scores for predicting mortality in patients with UTI.

摘要

快速 Pitt 评分(qPitt)是从 Pitt 菌血症评分衍生而来的一种新的预后评分,包括体温、收缩压、呼吸频率、心搏骤停和意识状态。我们的研究旨在比较 qPitt 与快速序贯器官衰竭评分(qSOFA)和 SOFA 对尿路感染(UTI)患者严重程度的评分。这是一项对诊断为 UTI 的患者进行的前瞻性观察研究。计算了 qPitt、qSOFA 和 SOFA 预测 30 天死亡率的 ROC 曲线下面积、敏感性和特异性,并进行了比较。共分析了 382 例 UTI 病例。qPitt≥2 与 30 天死亡率(18.8%比 5.9%,p<0.001)和更长的住院时间(6[1-11]天比 4[1-7]天,p<0.001)相关。然而,qPitt 预测 30 天死亡率的性能不如 qSOFA 和 SOFA(AUROC 分别为 0.692、0.832 和 0.806,p=0.010 和 p=0.041)。qPitt 的敏感性低于 qSOFA 和 SOFA(qSOFA 和 SOFA 均为 70.45%,p<0.001),特异性低于 qSOFA 但与 SOFA 相似(60.36%比 82.25%和 63.61%,p<0.001 和 p=0.742)。qPitt 对预测 UTI 患者死亡率具有中等的预后准确性,且其预测准确性不如 qSOFA 和 SOFA 评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc0/9352610/5401bef0b461/11739_2022_2927_Fig1_HTML.jpg

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