比较快速序贯器官衰竭评估 (Qsofa) 和国家早期预警评分 (News) 在 COVID-19 患者中的表现及其与结局的相关性。

Comparison of Quick Sequential Organ Failure Assessment (Qsofa) and National Early Warning Score (News) in Covid-19 Patients and its Correlation with the Outcome.

机构信息

Bangalore Medical College and Research Institute, Bangalore.

出版信息

J Assoc Physicians India. 2022 Apr;70(4):11-12.

Abstract

UNLABELLED

The recent outbreak of COVID 19 is a great threat to public health. Because of limitation of resources, the number of patients that can be monitored and treated in Intensive Care Units is restricted. Hence identifying medical patients at risk of deterioration at the initial stage by means of simple protocols based on physiological parameters is crucial. The qSOFA score was introduced as a rapid bedside clinical score to identify patients with a suspected infection that are at greater risk for a poor outcome. The National Early Warning Score (NEWS) was developed to improve the detection of and response to clinical deterioration in patients with acute illness. There is paucity of literature regarding the use of these scores in patients with COVID 19 infection. This study aims at comparing the scoring systems qSOFA and NEWS in the setting of COVID-19 infection and its correlation with the final outcome of the illness.

MATERIAL

It is a retrospective study in which patients presenting with COVID 19 infection(diagnosed by RT-PCR testing of nasopharyngeal and oral swab) between April 2021 to June 2021 were included. Scoring was done using both the scores at admission and the patients were followed up till the outcome. Outcome was defined as 5-day, 10-day and 15-day mortality after presentation. Predictive performance was expressed as discrimination (AUC). Subsequently, sensitivity and specificity were calculated.

OBSERVATION

A total of 100 patients were included in the study, of whom 17 died within 5 days and 37 died within 10 days and 30 died within 15 days after presentation. q SOFA had the best performance, compared to NEWS (5 day auc : .668, .621, 10-day auc: .580, .569, 15-day auc: .625, .511) with q SOFA having sensitivity of 90.2% while that of news being 95.1% where as specificity of q SOFA is 40.7% and that of NEWS is 47.5%.

CONCLUSION

qSOFA score is more accurate in predicting 5, 10 and 15-day mortality than NEWS score in COVID 19 patients. In resource limited settings, it is an inexpensive and simple tool for early identification of high risk COVID 19 patients.

摘要

目的

比较 qSOFA 和 NEWS 在 COVID-19 感染患者中的评分系统，并与疾病的最终结局相关联。

材料

这是一项回顾性研究，纳入了 2021 年 4 月至 6 月期间因 COVID-19 感染而就诊的患者（通过鼻咽和口腔拭子的 RT-PCR 检测诊断）。使用入院时的评分对患者进行评分，并对其进行随访直至结局。结局定义为就诊后 5 天、10 天和 15 天的死亡率。预测性能用区分度（AUC）表示。随后计算了敏感性和特异性。

观察

共有 100 例患者纳入研究，其中 17 例在就诊后 5 天内死亡，37 例在就诊后 10 天内死亡，30 例在就诊后 15 天内死亡。与 NEWS 相比，qSOFA 的表现最佳（5 天 AUC：.668、.621、10 天 AUC：.580、.569、15 天 AUC：.625、.511），qSOFA 的敏感性为 90.2%，而 NEWS 的敏感性为 95.1%，qSOFA 的特异性为 40.7%，而 NEWS 的特异性为 47.5%。