摘要
目的探讨快速序贯器官衰竭评分(q SOFA评分)在脓毒性休克患者的预后评估中的价值。方法收集急诊重症监护病房2013年1月-2014年1月收治的170例脓毒性休克患者的临床资料,根据28 d转归记录为存活组和死亡组,计算两组入院时q SOFA评分、急性生理学与慢性健康状况评分系统(APACHE)Ⅱ评分,通过受试者工作特征(ROC)曲线分析q SOFA评分、APACHEⅡ评分对脓毒性休克患者28 d内死亡的预测效能,评价q SOFA评分与APACHEⅡ评分的相关性。结果死亡组入院时q SOFA评分、APACHEⅡ评分均高于存活组,根据ROC曲线分析计算死亡组q SOFA评分、APACHEⅡ评分的曲线下面积分别为0.666、0.791。q SOFA评分以2分为截断点评价脓毒性休克预后的灵敏度为62.7%,特异度为61.1%,阳性预测值为56.0%,阴性预测值为67.4%,阳性似然比为1.61,阴性似然比0.61。APACHEⅡ评分以24分为截断点评价脓毒性休克预后的灵敏度为70.7%,特异度为80.0%,阳性预测值为73.6%,阴性预测值为67.3%,阳性似然比为3.54,阴性似然比为0.37。q SOFA评分与APACHEⅡ评分的相关系数为0.499。结论 q SOFA评分在急诊科早期评估脓毒性休克患者的预后有重要价值。
Objective To investigate the clinical value of quick sequential organ failure assessment（qSOFA）score in predicting the outcome of patients with septic shock.Methods We collected the clinical data of 170 patients with septic shock treated in the Emergency Intensive Care Unit between January 2013 and January 2014.According to the 28-day outcomes of the patients,they were recorded as survival group and non-survival group.We calculated the qSOFA score,acute physiology and chronic health evaluation（APACHE） Ⅱ score on patients＇ admission.Using receiver operating characteristic（ROC） curve,we analyzed the qSOFA score,the effect of APACHE Ⅱ score in predicting the28-day prognosis for patients with septic shock.The correlation between qSOFA score and APACHE Ⅱ score was also assessed.Results The qSOFA and APACHE Ⅱ scores in non-survivors were higher than those in the survivors.According to ROC curve analysis,the area under the curve for qSOFA score and APACHE II score was 0.666 and 0.791,respectively.For qSOFA score with 2 cut-off points to evaluate the prognosis of septic shock,the sensitivity was 62.7%,specificity was 61.1%,positive predictive value was 56.0%,negative predictive value was 67.4%,positive likelihood ratio was 1.61,and negative likelihood ratio was 0.61.For the APACHE Ⅱ score with 24 cut-off points to evaluate the prognosis of septic shock,the sensitivity was 70.7%,specificity was 80%,positive predictive value was 73.6%,negative predictive value was 67.3%,positive likelihood ratio was 3.54,and negative likelihood ratio was 0.37.The correlation coefficient of qSOFA score and APACHE II score was 0.499.Conclusion The qSOFA score is useful to evaluate the prognosis of the patients with septic shock early in Emergency Department.
出处
《华西医学》
CAS
2016年第10期1645-1648,共4页
West China Medical Journal
基金
四川省卫生和计划生育委员会科研课题(150169)~~
