Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, 480-1195, Aichi, Japan; Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA.
Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, 480-1195, Aichi, Japan.
J Infect Chemother. 2022 Dec;28(12):1687-1692. doi: 10.1016/j.jiac.2022.08.001. Epub 2022 Aug 7.
While acute empyema is a critical infectious disease showing a high mortality rate, there are no prognostic tools to evaluate the disease severity and prognosis for patients. We conducted a retrospective cohort to determine whether quick Sequential Organ Failure Assessment (qSOFA) and SOFA score can predict the disease severity and prognosis of acute empyema. A total of 53 patients were enrolled in the study. The mean age was 69 years and 41 patients (77%) were male. Twenty-two patients (42%) had multiple underlying diseases with the Charlson comorbidity index ≥3. The-30 days, and in-hospital deaths were 7 (13%) and 10 (19%), respectively. The area under the ROC curve of SOFA score and CCI for 30-day and in-hospital deaths were 0.814 (p = 0.073) and 0.752 (p = 0.082), 0.848 (p = 0.07) and 0.762 (p = 0.011), respectively. Univariate analysis showed that qSOFA ≥2 and SOFA score ≥2, isolation of potentially drug-resistant (PDR) pathogen, high CCI (≥3), performance status of 2-4, surgical intervention, and anaerobic bacteria involvement were prognostic factors. Of these, multivariate logistic regression analysis showed that qSOFA ≥2 and SOFA score ≥2 (p = 0.011), isolation of PDR pathogen (p = 0.005), and high CCI (≥3) (p = 0.015) were independently poor prognostic factors. We concluded that qSOFA and SOFA scores could predict the disease severity and prognosis in acute empyema. Additionally, isolation of PDR pathogens and high CCI could be poor prognostic factors for patients.
虽然急性脓胸是一种死亡率很高的危急感染性疾病，但目前尚无评估疾病严重程度和预后的预测工具。我们进行了一项回顾性队列研究，以确定快速序贯器官衰竭评估（qSOFA）和 SOFA 评分是否可以预测急性脓胸的疾病严重程度和预后。共有 53 名患者入组本研究。患者的平均年龄为 69 岁，41 名（77%）为男性。22 名（42%）患者存在多种基础疾病，Charlson 合并症指数≥3。30 天和住院内死亡率分别为 7 例（13%）和 10 例（19%）。SOFA 评分和 CCI 对 30 天和住院内死亡的 ROC 曲线下面积分别为 0.814（p=0.073）和 0.752（p=0.082），0.848（p=0.07）和 0.762（p=0.011）。单因素分析表明，qSOFA≥2 和 SOFA 评分≥2、分离出潜在耐药菌（PDR）病原体、CCI 较高（≥3）、体力状态 2-4 级、手术干预和厌氧菌参与是预后因素。其中，多因素逻辑回归分析表明，qSOFA≥2 和 SOFA 评分≥2（p=0.011）、分离出 PDR 病原体（p=0.005）和 CCI 较高（≥3）（p=0.015）是独立的不良预后因素。我们的结论是，qSOFA 和 SOFA 评分可以预测急性脓胸的疾病严重程度和预后。此外，分离出 PDR 病原体和较高的 CCI 可能是患者的不良预后因素。
