Günaydın Yahya Kemal, Kocaşaban Dilber Üçöz, Güler Sertaç, Demirtaş Erdal, Çövüt Yeşim, Öztürk Mitat Can, İlgün Jiyan Deniz, Akıllı Nazire Belgin
University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey.
University of Health Sciences Konya City Hospital, Konya, Turkey.
Yonago Acta Med. 2024 Aug 27;67(3):225-232. doi: 10.33160/yam.2024.08.009. eCollection 2024 Aug.
Recent studies have analyzed the qSOFA (quick sequential organ failure assessment) score as a prognostic indicator in many diseases, particularly sepsis. However, the effect of qSOFA score on prognosis and mortality in critical care patients has not been sufficiently analyzed. There is not enough data, especially regarding its use as critical care mortality and prognosis scoring. In this study, we aimed to analyze the effect of qSOFA score on mortality and prognosis in critical care unit (CCU) patients.
This study was conducted retrospectively using the chart review method. The APACHE II (Acute Physiology and Chronic Health Evaluation II) and SOFA (Sequential Organ Failure Assessment) scores of patients admitted to our CCU were compared with the qSOFA score. In addition, the need for intubation and mechanical ventilation, short- and long term mortality rates, the relationship between blood gas lactate values and qSOFA score were analyzed.
A total of 1816 patients were included in the study. During critical care follow-up, 374 (20.6%) of our patients died, and at the end of 6 months, 796 (43.8%) of our patients died. A statistically significant association was found between in-hospital mortality and qSOFA, SOFA scores and lactate levels ( = 0.001, = 0.001, = 0.01 respectively). A statistically significant association was found between 6-month mortality and SOFA score only. ( = 0.001) The SOFA score appeared to be the most successful predictor of mortality. The cut-off for mortality using the ROC curve was ≥ 7 [sensitivity 78.1%; specificity 85.9%; AUC 0.91; 95% confidence interval (CI), 0.89 to 0.92; = 0.001]. qSOFA scoring also performed well. The cut-off value for mortality using the ROC curve was ≥ 2 (sensitivity 42.5%; specificity 93.9%; AUC 0.83;95% CI, 0.80-0.85; = 0.001).
We believe that the qSOFA score can be used as a marker for in-hospital mortality and prognosis in critical care patients. Especially in cases where the qSOFA score is ≥ 2, it provides valuable information regarding mortality and prognosis.
近期研究已将qSOFA(快速序贯器官衰竭评估)评分分析为多种疾病(尤其是脓毒症)的预后指标。然而,qSOFA评分对重症监护患者预后和死亡率的影响尚未得到充分分析。目前没有足够的数据,特别是关于其作为重症监护死亡率和预后评分的应用。在本研究中,我们旨在分析qSOFA评分对重症监护病房(CCU)患者死亡率和预后的影响。
本研究采用回顾性病历审查方法进行。将入住我们CCU的患者的APACHE II(急性生理与慢性健康状况评估II)和SOFA(序贯器官衰竭评估)评分与qSOFA评分进行比较。此外,分析了插管和机械通气的需求、短期和长期死亡率、血气乳酸值与qSOFA评分之间的关系。
本研究共纳入1816例患者。在重症监护随访期间,我们的患者中有374例(20.6%)死亡,在6个月末,有796例(43.8%)患者死亡。发现住院死亡率与qSOFA、SOFA评分及乳酸水平之间存在统计学显著关联(分别为P = 0.001、P = 0.001、P = 0.01)。仅发现6个月死亡率与SOFA评分之间存在统计学显著关联(P = 0.001)。SOFA评分似乎是最成功的死亡率预测指标。使用ROC曲线得出的死亡率临界值为≥7[敏感度78.1%;特异度85.9%;AUC 0.91;95%置信区间(CI),0.89至0.92;P = 0.001]。qSOFA评分表现也良好。使用ROC曲线得出的死亡率临界值为≥2(敏感度42.5%;特异度93.9%;AUC 0.83;95% CI,0.80 - 0.85;P = 0.001)。
我们认为qSOFA评分可作为重症监护患者住院死亡率和预后的标志物。特别是在qSOFA评分≥2的情况下,它提供了关于死亡率和预后的有价值信息。