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脓毒症和脓毒性休克的筛查、预测及评估工具:一项全面综述

Tools for Screening, Predicting, and Evaluating Sepsis and Septic Shock: A Comprehensive Review.

作者信息

Aggrawal Kanishk, Verma Sakshi, Stoltzfus Mason T, Singh Bhupinder, Anamika Fnu, Jain Rohit

机构信息

Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND.

Internal Medicine, Government Medical College, Amritsar, Amritsar, IND.

出版信息

Cureus. 2024 Aug 18;16(8):e67137. doi: 10.7759/cureus.67137. eCollection 2024 Aug.

Abstract

Sepsis is characterized by life-threatening organ dysfunction due to dysregulated host response to infection. It can progress to cause circulatory and cellular/metabolic abnormalities, resulting in septic shock that may significantly increase mortality. The pathophysiology of sepsis involves a complex interplay of invading pathogens and the body's immune defense, causing alteration in normal homeostasis, eventually leading to derangements in the cellular, humoral, circulatory, and metabolic functions. Several scoring systems have been developed to rapidly predict or suspect sepsis, such as Sequential Organ Failure Assessment (SOFA), modified SOFA (mSOFA), quick SOFA (qSOFA), shock index (SI), and modified SI (mSI). Each of these scores has been utilized for triaging patients with sepsis, and as per medical advancements these scoring systems have been modified to include or exclude certain criteria to improve their clinical utility. This review aims to compare the individual scores and their usage for sepsis that may be used for laying the foundation for early recognition and prediction of sepsis and for formulating more precise definitions in the future.

摘要

脓毒症的特征是由于宿主对感染的反应失调而导致危及生命的器官功能障碍。它可进展导致循环和细胞/代谢异常,进而引发脓毒性休克,这可能显著增加死亡率。脓毒症的病理生理学涉及入侵病原体与机体免疫防御的复杂相互作用,导致正常内环境稳态改变,最终引起细胞、体液、循环和代谢功能紊乱。已经开发了几种评分系统来快速预测或怀疑脓毒症,如序贯器官衰竭评估(SOFA)、改良SOFA(mSOFA)、快速SOFA(qSOFA)、休克指数(SI)和改良SI(mSI)。这些评分中的每一种都已用于对脓毒症患者进行分诊,并且随着医学进步,这些评分系统已被修改以纳入或排除某些标准,以提高其临床实用性。本综述旨在比较各个评分及其在脓毒症中的应用,这可能为脓毒症的早期识别和预测奠定基础,并在未来制定更精确的定义。

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