Devia Jaramillo German, Erazo Guerrero Lilia, Florez Zuñiga Natalia, Martin Cuesta Ronal Mauricio
Department of Emergency Medicine, Hospital Universitario Fundación Santafé de Bogotá, Bogotá 110111, Colombia.
School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia.
J Clin Med. 2024 Dec 20;13(24):7787. doi: 10.3390/jcm13247787.
Sepsis is a disease with a high mortality rate, which emphasizes the importance of developing tools for the early identification of high-risk patients and to initiate timely treatments to reduce mortality. The SIL score is a scale that uses the shock index and arterial lactate level to identify early on the patients that are at a high risk of in-hospital mortality due to sepsis. The purpose of this study was to validate the SIL score as a tool for estimating the probability of sepsis in-hospital mortality from the triage room in emergency departments. Additionally, the advantages of the SIL score were evaluated in comparison with NEWS and SOFA. All of the patients with suspected sepsis were prospectively recruited from the triage room in an emergency department. The SIL score, as well as other evaluation scales, were calculated for these patients. The sensitivity, specificity, predictive values, and areas under the curve (AUC) of each scale were assessed to predict mortality. This study included 315 patients. The total mortality of the cohort was 20.4%. Of the total population, 35.5% were in septic shock. The SIL, NEWS, and SOFA scores had similar sensitivities, approximately 60%; however, a higher specificity was documented in the SIL score over the other scales (67%). The SIL score demonstrated superior discriminatory ability compared to the NEWS and SOFA scores (AUC = 0.754, = 0.01). The SIL score proved to be a useful tool for predicting in-hospital mortality due to sepsis. Its discriminatory ability surpasses that of other evaluated scales. Therefore, the SIL score can be successfully implemented in the triage room of emergency departments to improve the identification and early management of patients with sepsis.
脓毒症是一种死亡率很高的疾病,这凸显了开发工具以早期识别高危患者并及时启动治疗以降低死亡率的重要性。SIL评分是一种利用休克指数和动脉血乳酸水平来早期识别因脓毒症而有较高院内死亡风险患者的量表。本研究的目的是验证SIL评分作为一种从急诊科分诊室评估脓毒症院内死亡概率的工具。此外,还将SIL评分与NEWS和SOFA进行比较,评估其优势。所有疑似脓毒症患者均前瞻性地从急诊科分诊室招募。为这些患者计算了SIL评分以及其他评估量表。评估每个量表的敏感性、特异性、预测值和曲线下面积(AUC)以预测死亡率。本研究纳入了315例患者。该队列的总死亡率为20.4%。在总人口中,35.5%处于脓毒性休克状态。SIL、NEWS和SOFA评分的敏感性相似,约为60%;然而,SIL评分的特异性高于其他量表(67%)。与NEWS和SOFA评分相比,SIL评分显示出更好的鉴别能力(AUC = 0.754,P = 0.01)。SIL评分被证明是预测脓毒症院内死亡的有用工具。其鉴别能力超过了其他评估量表。因此,SIL评分可在急诊科分诊室成功应用,以改善脓毒症患者的识别和早期管理。