用于评估急诊科COVID-19患者死亡率、早期细菌感染及入住重症监护病房情况的NEWS、qSOFA和SIRS评分表现

Performance of NEWS, qSOFA, and SIRS Scores for Assessing Mortality, Early Bacterial Infection, and Admission to ICU in COVID-19 Patients in the Emergency Department.

作者信息

Alencar Julio, Marina Gómez Gómez Luz, Cortez Andre Lazzeri, Possolo de Souza Heraldo, Levin Anna Sara, Salomão Matias Chiarastelli

机构信息

Departamento de Emergência Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Departamento de Moléstias Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

Front Med (Lausanne). 2022 Mar 2;9:779516. doi: 10.3389/fmed.2022.779516. eCollection 2022.

SARS-CoV-2 infection has a wide spectrum of presentations, from asymptomatic to pneumonia and sepsis. Risk scores have been used as triggers for protocols that combine several interventions for early management of sepsis. This study tested the accuracy of the score SIRS, qSOFA, and NEWS in predicting outcomes, including mortality and bacterial infection, in patients admitted to the emergency department (ED) during the COVID-19 pandemic. We described 2,473 cases of COVID-19 admitted to the ED of the largest referral hospital for severe COVID-19 in Brazil during the pandemic. SIRS, qSOFA and NEWS scores showed a poor performance as prognostic scores. However, NEWS score had a high sensitivity to predict in-hospital death (0.851), early bacterial infection (0.851), and ICU admission (0.868), suggesting that it may be a good screening tool for severe cases of COVID-19, despite its low specificity.

严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染有广泛的表现，从无症状到肺炎和脓毒症。风险评分已被用作一些方案的触发因素，这些方案结合了多种干预措施用于脓毒症的早期管理。本研究测试了全身炎症反应综合征（SIRS）、快速序贯器官衰竭评估（qSOFA）和国家早期预警评分（NEWS）在预测2019冠状病毒病大流行期间急诊科收治患者的结局（包括死亡率和细菌感染）方面的准确性。我们描述了大流行期间巴西最大的重症2019冠状病毒病转诊医院急诊科收治的2473例2019冠状病毒病病例。SIRS、qSOFA和NEWS评分作为预后评分表现不佳。然而，NEWS评分在预测院内死亡（0.851）、早期细菌感染（0.851）和重症监护病房（ICU）入院（0.868）方面具有较高的敏感性，这表明尽管其特异性较低，但它可能是2019冠状病毒病重症病例的良好筛查工具。