Department of Pharmacy, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
Department of Pharmacy, University Town Hospital Affiliated of Chongqing Medical University, Chongqing, China.
PLoS One. 2022 Apr 15;17(4):e0266755. doi: 10.1371/journal.pone.0266755. eCollection 2022.
To identify and compare prognostic accuracy of quick Sequential Organ Failure Assessment (qSOFA) score, Systemic Inflammatory Response Syndrome (SIRS) criteria, and National Early Warning Score (NEWS) to predict mortality in patients with suspected sepsis.
This meta-analysis followed accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched PubMed, EMBASE, Web of Science, and the Cochrane Library databases from establishment of the database to November 29, 2021. The pooled sensitivity and specificity with 95% CIs were calculated using a bivariate random-effects model (BRM). Hierarchical summary receiver operating characteristic (HSROC) curves were generated to assess the overall prognostic accuracy.
Data of 62338 patients from 26 studies were included in this meta-analysis. qSOFA had the highest specificity and the lowest sensitivity with a specificity of 0.82 (95% CI: 0.76-0.86) and a sensitivity of 0.46 (95% CI: 0.39-0.53). SIRS had the highest sensitivity and the lowest specificity with a sensitivity of 0.82 (95% CI: 0.78-0.85) and a specificity 0.24 (95% CI: 0.19-0.29). NEWS had both an intermediate sensitivity and specificity with a sensitivity of 0.73 (95% CI: 0.63-0.81) and a specificity 0.52 (95% CI: 0.39-0.65). qSOFA showed higher overall prognostic accuracy than SIRS and NEWS by comparing HSROC curves.
Among qSOFA, SIRS and NEWS, qSOFA showed higher overall prognostic accuracy than SIRS and NEWS. However, no scoring system has both high sensitivity and specificity for predicting the accuracy of mortality in patients with suspected sepsis.
确定和比较快速序贯器官衰竭评估（qSOFA）评分、全身性炎症反应综合征（SIRS）标准和国家早期预警评分（NEWS）预测疑似脓毒症患者死亡率的准确性。
本荟萃分析符合系统评价和荟萃分析的首选报告项目（PRISMA）声明的建议。我们从数据库建立到 2021 年 11 月 29 日，在 PubMed、EMBASE、Web of Science 和 Cochrane 图书馆数据库中进行了检索。使用双变量随机效应模型（BRM）计算汇总敏感性和特异性及其 95%CI。生成分层汇总受试者工作特征（HSROC）曲线以评估整体预后准确性。
本荟萃分析纳入了 26 项研究的 62338 名患者的数据。qSOFA 具有最高的特异性和最低的敏感性，特异性为 0.82（95%CI：0.76-0.86），敏感性为 0.46（95%CI：0.39-0.53）。SIRS 具有最高的敏感性和最低的特异性，敏感性为 0.82（95%CI：0.78-0.85），特异性为 0.24（95%CI：0.19-0.29）。NEWS 具有中等的敏感性和特异性，敏感性为 0.73（95%CI：0.63-0.81），特异性为 0.52（95%CI：0.39-0.65）。通过比较 HSROC 曲线，qSOFA 的整体预后准确性高于 SIRS 和 NEWS。
在 qSOFA、SIRS 和 NEWS 中，qSOFA 的整体预后准确性高于 SIRS 和 NEWS。然而，没有任何评分系统对预测疑似脓毒症患者死亡率的准确性具有高敏感性和特异性。
