Dronamraju Sameera, Agrawal Sachin, Kumar Sunil, Acharya Sourya, Gaidhane Shilpa, Wanjari Anil, Jaiswal Praraj, Bawiskar Nipun
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.
Indian J Crit Care Med. 2022 Oct;26(10):1099-1105. doi: 10.5005/jp-journals-10071-24323.
Though many scoring systems for prognostication of sepsis are available in the intensive care set-up, predisposition, insult, response, and organ dysfunction (PIRO) score helps to assess each patient and evaluate response to therapy. There are few studies comparing the efficacy of PIRO score with other sepsis scores. Hence, our study was planned to compare PIRO score with acute physiology and chronic health evaluation IV (APACHE IV) score and sequential (sepsis-related) organ failure assessment (SOFA) score in predicting the mortality of intensive care patients with sepsis.
This prospective cross-sectional study was done in the medical intensive care unit (MICU) from August 2019 to September 2021 among patients above 18 years of age with the diagnosis of sepsis. Predisposition, insult, response, and organ dysfunction score, SOFA score, and APACHE IV score on admission and at day 3 were calculated and statistically analyzed in the terms of outcome.
A total of 280 patients fulfilling the inclusion criteria were included in the study, the mean age was 59.38 ± 15.9 years. There was a significant association of PIRO score, SOFA score, and APACHE IV score on admission and at day 3 with mortality (-value <0.05). Among all three parameters, the PIRO score on admission and at day 3 was the best predictor of mortality at cut-off points of >14 and >16 with 92.50% and 96.50% chances of correctly predicting mortality, respectively.
Predisposition, insult, response, and organ dysfunction score can be considered as a strong predictor of prognostication of patients with sepsis admitted to the intensive care unit (ICU) and predict mortality. It should be routinely used as it is a simple and comprehensive score.
Dronamraju S, Agrawal S, Kumar S, Acharya S, Gaidhane S, Wanjari A, . Comparison of PIRO, APACHE IV, and SOFA Scores in Predicting Outcome in Patients with Sepsis Admitted to Intensive Care Unit: A Two-year Cross-sectional Study at Rural Teaching Hospital. Indian J Crit Care Med 2022;26(10):1099-1105.
尽管在重症监护环境中有许多用于脓毒症预后评估的评分系统，但易感性、损伤、反应和器官功能障碍（PIRO）评分有助于评估每位患者并评估对治疗的反应。很少有研究比较PIRO评分与其他脓毒症评分的疗效。因此，我们的研究旨在比较PIRO评分与急性生理学和慢性健康状况评估IV（APACHE IV）评分以及序贯（脓毒症相关）器官衰竭评估（SOFA）评分在预测重症监护脓毒症患者死亡率方面的差异。
这项前瞻性横断面研究于2019年8月至2021年9月在医学重症监护病房（MICU）对18岁以上脓毒症诊断患者进行。计算入院时和第3天的易感性、损伤、反应和器官功能障碍评分、SOFA评分和APACHE IV评分，并根据结果进行统计分析。
共有280例符合纳入标准的患者纳入研究，平均年龄为59.38±15.9岁。入院时和第3天的PIRO评分、SOFA评分和APACHE IV评分与死亡率有显著相关性（P值<0.05）。在所有三个参数中，入院时和第3天的PIRO评分是死亡率的最佳预测指标，截断点分别为>14和>16时，正确预测死亡率的概率分别为92.50%和96.50%。
易感性、损伤、反应和器官功能障碍评分可被视为重症监护病房（ICU）脓毒症患者预后的有力预测指标，并可预测死亡率。由于它是一个简单而全面的评分，应常规使用。
Dronamraju S, Agrawal S, Kumar S, Acharya S, Gaidhane S, Wanjari A, . 比较PIRO、APACHE IV和SOFA评分在预测重症监护病房脓毒症患者结局中的作用：农村教学医院的两年横断面研究。《印度重症监护医学杂志》2022；26(10):1099 - 1105。
