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序贯器官衰竭评估(SOFA)和快速序贯器官衰竭评估(qSOFA)对新型冠状病毒肺炎(COVID-19)患者院内死亡率的预测价值:罗马尼亚的一项单中心研究

Predictive Value of SOFA and qSOFA for In-Hospital Mortality in COVID-19 Patients: A Single-Center Study in Romania.

作者信息

Citu Cosmin, Citu Ioana Mihaela, Motoc Andrei, Forga Marius, Gorun Oana Maria, Gorun Florin

机构信息

Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.

Department of Internal Medicine I, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.

出版信息

J Pers Med. 2022 May 26;12(6):878. doi: 10.3390/jpm12060878.

Abstract

Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease's severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to assess the prognostic value of SOFA and qSOFA scoring systems for in-hospital mortality among patients with COVID-19. The study included 133 patients with COVID-19 proven by reverse transcriptase polymerase chain reaction (RT-PCR) admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania between 1 October 2020 and 15 March 2021. Data on clinical features and laboratory findings on admission were collected from electronic medical records and used to compute SOFA and qSOFA. Mean SOFA and qSOFA values were higher in the non-survivor group compared to survivors (3.5 vs. 1 for SOFA and 2 vs. 1 for qSOFA, respectively). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy, both risk scores being excellent predictors of in-hospital mortality, with ROC-AUC values of 0.800 for SOFA and 0.794 for qSOFA. The regression analysis showed that for every one-point increase in SOFA score, mortality risk increased by 1.82 and for every one-point increase in qSOFA score, mortality risk increased by 5.23. In addition, patients with SOFA and qSOFA above the cut-off values have an increased risk of mortality with ORs of 7.46 and 11.3, respectively. In conclusion, SOFA and qSOFA are excellent predictors of in-hospital mortality among COVID-19 patients. These scores determined at admission could help physicians identify those patients at high risk of severe COVID-19.

摘要

新型冠状病毒肺炎(COVID-19)大流行爆发两年后,该疾病仍在全球范围内夺去生命。评估患者入院时疾病的严重程度可能有助于降低COVID-19患者的死亡率。本研究旨在评估序贯器官衰竭评估(SOFA)和快速序贯器官衰竭评估(qSOFA)评分系统对COVID-19患者院内死亡率的预后价值。该研究纳入了2020年10月1日至2021年3月15日期间在罗马尼亚蒂米什瓦拉市紧急临床医院住院的133例经逆转录聚合酶链反应(RT-PCR)确诊的COVID-19患者。从电子病历中收集入院时的临床特征和实验室检查结果数据,并用于计算SOFA和qSOFA评分。与存活患者相比,非存活患者组的平均SOFA和qSOFA值更高(SOFA分别为3.5对1,qSOFA分别为2对1)。进行了受试者工作特征(ROC)和曲线下面积(AUC)分析以确定判别准确性,两个风险评分都是院内死亡率的优秀预测指标,SOFA的ROC-AUC值为0.800,qSOFA的ROC-AUC值为0.794。回归分析表明,SOFA评分每增加1分,死亡风险增加1.82,qSOFA评分每增加1分,死亡风险增加5.23。此外,SOFA和qSOFA高于临界值的患者死亡风险增加,其比值比分别为7.46和11.3。总之,SOFA和qSOFA是COVID-19患者院内死亡率的优秀预测指标。入院时确定的这些评分有助于医生识别那些有严重COVID-19高风险的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1d7/9224933/82445a4469f8/jpm-12-00878-g001.jpg

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