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乳酸增强型快速序贯器官衰竭评估(LqSOFA)评分作为脓毒症患者院内死亡率的预测指标:系统评价与荟萃分析

Lactate-enhanced-qSOFA (LqSOFA) score as a predictor of in-hospital mortality in patients with sepsis: systematic review and meta-analysis.

作者信息

Moncada-Gutiérrez Diego, Vásquez-Tirado Gustavo Adolfo, Meregildo-Rodríguez Edinson Dante, Quispe-Castañeda Claudia Vanessa, Cuadra-Campos María, Abanto-Montalván Percy Hernán, Guzmán-Aguilar Wilson Marcial, Liñán-Díaz Leslie Jacqueline, Alva-Guarniz Hugo Nelson, Rodríguez-Chávez Luis Ángel

机构信息

Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Perú.

Unidad de Cuidados Intensivos, Hospital Regional Docente de Trujillo, Trujillo, Perú.

出版信息

Eur J Trauma Emerg Surg. 2025 Jan 24;51(1):33. doi: 10.1007/s00068-024-02757-8.

Abstract

INTRODUCTION

Sepsis is a systemic process that refers to a deregulated immune response of the host against an infectious agent, involving multiple organ dysfunction. It is rapidly progressive and has a dismal prognosis, with high mortality rates. For this reason, it is necessary to have a tool for early recognition of these patients, with the aim of treating them appropriately in a timely manner.

METHODS

This research is a systematic review based on bibliography indexed in four online scientific databases for studies published since inception to February 2024, which was obtained through the use of a search strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.

RESULTS

The meta-analysis revealed that among 23,551 patients diagnosed with sepsis, 5,825 had a positive LqSOFA, and 3,086 experienced the primary outcome (mortality). For LqSOFA, a sensitivity of 0.61 (95% CI 0.60-0.63), specificity of 0.81 (95% CI 0.80-0.81), positive likelihood ratio (LR+) of 3.46 (95% CI 2.86-4.18), negative likelihood ratio (LR-) of 0.47 (95% CI 0.38-0.59), and odds ratio (OR) of 7.43 (95% CI 6.01-9.20) were determined. The area under the curve (AUC) was 0.807.

CONCLUSIONS

The LqSOFA score demonstrates a good predictive capacity for in-hospital mortality in septic patients, showing clinically significant levels of sensitivity (69%) and specificity (79%).

摘要

引言

脓毒症是一种全身性过程,指宿主针对感染因子的免疫反应失调,涉及多器官功能障碍。它进展迅速,预后不佳,死亡率高。因此,有必要拥有一种早期识别这些患者的工具,以便及时对他们进行适当治疗。

方法

本研究是一项基于四个在线科学数据库中自数据库建立至2024年2月发表的文献的系统评价,通过搜索策略获取相关文献。确定了八项研究进行定量分析并纳入我们的荟萃分析。

结果

荟萃分析显示,在23551例被诊断为脓毒症的患者中,5825例LqSOFA呈阳性,3086例发生主要结局(死亡)。对于LqSOFA,确定其敏感性为0.61(95%CI 0.60 - 0.63),特异性为0.81(95%CI 0.80 - 0.81),阳性似然比(LR+)为3.46(95%CI 2.86 - 4.18),阴性似然比(LR-)为0.47(95%CI 0.38 - 0.59),比值比(OR)为7.43(95%CI 6.01 - 9.20)。曲线下面积(AUC)为0.807。

结论

LqSOFA评分对脓毒症患者的院内死亡率显示出良好的预测能力,其敏感性(69%)和特异性(79%)达到具有临床意义的水平。

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