COVID-19 非 ICU 患者中使用脓毒症评分预测呼吸衰竭和死亡的早期应用。
The early use of sepsis scores to predict respiratory failure and mortality in non-ICU patients with COVID-19.
机构信息
Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain.
Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Instituto de investigación del Hospital Universitario 12 de Octubre (i+12), Madrid, Spain.
出版信息
Rev Clin Esp (Barc). 2022 May;222(5):293-298. doi: 10.1016/j.rceng.2020.10.004. Epub 2021 Feb 17.
Abstract
This observational retrospective study aimed to investigate the usefulness of Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), National Early Warning Score (NEWS), and quick NEWS in predicting respiratory failure and death among patients with COVID-19 hospitalized outside of intensive care units (ICU). We included 237 adults hospitalized with COVID-19 who were followed-up on for one month or until death. Respiratory failure was defined as a PaO/FiO ratio ≤200mmHg or the need for mechanical ventilation. Respiratory failure occurred in 77 patients (32.5%), 29 patients (12%) were admitted to the ICU, and 49 patients (20.7%) died. Discrimination of respiratory failure was slightly higher in NEWS, followed by SOFA. Regarding mortality, SOFA was more accurate than the other scores. In conclusion, sepsis scores are useful for predicting respiratory failure and mortality in COVID-19 patients. A NEWS score ≥4 was found to be the best cutoff point for predicting respiratory failure.
摘要
这项观察性回顾性研究旨在探讨序贯器官衰竭评估（SOFA）、快速 SOFA（qSOFA）、国家早期预警评分（NEWS）和快速 NEWS 在预测 COVID-19 患者在重症监护病房（ICU）外住院期间发生呼吸衰竭和死亡的有用性。我们纳入了 237 名因 COVID-19 住院的成年人，对其进行了为期一个月或直至死亡的随访。呼吸衰竭定义为 PaO/FiO 比值≤200mmHg 或需要机械通气。77 名患者（32.5%）发生呼吸衰竭，29 名患者（12%）转入 ICU，49 名患者（20.7%）死亡。NEWS 对呼吸衰竭的区分度略高于 SOFA。关于死亡率，SOFA 比其他评分更准确。总之，脓毒症评分可用于预测 COVID-19 患者的呼吸衰竭和死亡率。NEWS 评分≥4 被发现是预测呼吸衰竭的最佳截断点。
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本文引用的文献
1
A Novel Coronavirus from Patients with Pneumonia in China, 2019.2019 年中国肺炎患者中的一种新型冠状病毒。
N Engl J Med. 2020 Feb 20;382(8):727-733. doi: 10.1056/NEJMoa2001017. Epub 2020 Jan 24.
2
The effectiveness of a national early warning score as a triage tool for activating a rapid response system in an outpatient setting: A retrospective cohort study.一项关于国家早期预警评分作为门诊环境中启动快速反应系统的分诊工具的有效性的回顾性队列研究。
Medicine (Baltimore). 2019 Dec;98(52):e18475. doi: 10.1097/MD.0000000000018475.
3
Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score.预测急诊科疑似脓毒症患者的死亡率：一项比较 qSOFA、SIRS 和国家早期预警评分的回顾性队列研究。
PLoS One. 2019 Jan 25;14(1):e0211133. doi: 10.1371/journal.pone.0211133. eCollection 2019.
4
A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection.快速序贯器官衰竭评估评分与国家早期预警评分在非 ICU 感染/非感染患者中的比较。
Crit Care Med. 2018 Dec;46(12):1923-1933. doi: 10.1097/CCM.0000000000003359.
5
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Ann Intern Med. 2018 Feb 20;168(4):266-275. doi: 10.7326/M17-2820. Epub 2018 Feb 6.
6
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Acute respiratory distress syndrome: the Berlin Definition.急性呼吸窘迫综合征：柏林定义。
JAMA. 2012 Jun 20;307(23):2526-33. doi: 10.1001/jama.2012.5669.
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