血管活性正性肌力评分与序贯器官衰竭评估心血管评分在重症监护中的比较。
Vasoactive Inotropic Score compared to the sequential organ failure assessment cardiovascular score in intensive care.
机构信息
Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
Division of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
出版信息
Acta Anaesthesiol Scand. 2023 Oct;67(9):1219-1228. doi: 10.1111/aas.14287. Epub 2023 Jun 5.
BACKGROUND
The cardiovascular component of the sequential organ failure assessment (cvSOFA) score may be outdated because of changes in intensive care. Vasoactive Inotropic Score (VIS) represents the weighted sum of vasoactive and inotropic drugs. We investigated the association of VIS with mortality in the general intensive care unit (ICU) population and studied whether replacing cvSOFA with a VIS-based score improves the accuracy of the SOFA score as a predictor of mortality.
METHODS
We studied the association of VIS during the first 24 h after ICU admission with 30-day mortality in a retrospective study on adult medical and non-cardiac emergency surgical patients admitted to Kuopio University Hospital ICU, Finland, in 2013-2019. We determined the area under the receiver operating characteristic curve (AUROC) for the original SOFA and for SOFA , where cvSOFA was replaced with maximum VIS (VIS ) categories.
RESULTS
Of 8079 patients, 1107 (13%) died within 30 days. Mortality increased with increasing VIS . AUROC was 0.813 (95% confidence interval [CI], 0.800-0.825) for original SOFA and 0.822 (95% CI: 0.810-0.834) for SOFA , p < .001.
CONCLUSION
Mortality increased consistently with increasing VIS . Replacing cvSOFA with VIS improved the predictive accuracy of the SOFA score.
背景
序贯器官衰竭评估（cvSOFA）评分的心血管成分可能已经过时，因为重症监护发生了变化。血管活性和正性肌力药物评分（VIS）代表血管活性和正性肌力药物的加权总和。我们研究了 VIS 与普通重症监护病房（ICU）人群死亡率之间的关系，并研究了用基于 VIS 的评分替代 cvSOFA 是否可以提高 SOFA 评分作为死亡率预测指标的准确性。
方法
我们在一项回顾性研究中研究了 2013-2019 年芬兰库奥皮奥大学医院 ICU 收治的成年内科和非心脏急诊手术患者 ICU 入院后 24 小时内 VIS 与 30 天死亡率之间的关系。我们确定了原始 SOFA 和 SOFA 的受试者工作特征曲线下面积（AUROC），其中 cvSOFA 用最大 VIS（VIS）类别替代。
结果
在 8079 名患者中，1107 名（13%）在 30 天内死亡。死亡率随 VIS 的增加而增加。原始 SOFA 的 AUROC 为 0.813（95%可信区间[CI]，0.800-0.825），SOFA 的 AUROC 为 0.822（95% CI：0.810-0.834），p<0.001。
结论
死亡率随 VIS 的增加而持续增加。用 VIS 替代 cvSOFA 提高了 SOFA 评分的预测准确性。
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