Noegroho Bambang S, Adi Kuncoro, Mustafa Akhmad, Haq Rais Syaeful, Wijayanti Zola, Liarto Jason
Urology Department, Hasan Sadikin Academic Medical Center, Universitas Padjadjaran, Bandung, Indonesia.
Asian J Urol. 2023 Apr;10(2):201-207. doi: 10.1016/j.ajur.2021.11.003. Epub 2021 Nov 19.
Fournier's gangrene is a rare but life-threatening infection disease with high mortality rate. The quick Sepsis-related Organ Failure Assessment (qSOFA) is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome. The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier's gangrene patients.
This study is a case control with retrospective review of Fournier's gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria. Participants were divided into two groups according to qSOFA score as high qSOFA (2-3) and low qSOFA (0-1).
From 69 patients, the mortality rate was 24.6%. The sensitivity of qSOFA score to predict mortality was 88.2%; the specificity was 94.2%; positive predictive value was 83.3%; negative predictive value was 96.1%; positive likelihood ratio was 15.2; negative likelihood ratio was 0.12; and the area under the receiver operating characteristic curve of qSOFA was 94.2%. There was significant association between qSOFA scale and mortality with -value of 0.0001. The qSOFA score has strong positive correlation with Fournier's Gangrene Severity Index (<0.0001, =0.704).
qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier's gangrene patients.
福尼尔坏疽是一种罕见但危及生命的感染性疾病,死亡率很高。快速脓毒症相关器官功能衰竭评估(qSOFA)是一种新的、更简单的评分系统,可识别疑似感染且预后较差风险更高的患者。本研究的目的是探讨qSOFA在确定福尼尔坏疽患者预后中的作用。
本研究为病例对照研究,对2013年1月至2017年12月在哈桑·萨迪金医院接受治疗且符合纳入标准的福尼尔坏疽患者进行回顾性分析。根据qSOFA评分将参与者分为两组,即高qSOFA组(2 - 3分)和低qSOFA组(0 - 1分)。
69例患者的死亡率为24.6%。qSOFA评分预测死亡率的敏感性为88.2%;特异性为94.2%;阳性预测值为83.3%;阴性预测值为96.1%;阳性似然比为15.2;阴性似然比为0.12;qSOFA的受试者工作特征曲线下面积为94.2%。qSOFA评分与死亡率之间存在显著关联,P值为0.0001。qSOFA评分与福尼尔坏疽严重程度指数呈强正相关(P<0.0001,r = 0.704)。
qSOFA评分系统具有较高的预后价值,可用于确定福尼尔坏疽患者的预后。