摘要
【目的】探讨快速序贯器官衰竭评分(qSOFA)在重症医学科(ICU)感染患者预后中的预测价值。【方法】回顾性分析本院ICU收治的80例感染患者的临床资料,计算其qSOFA、快速急诊内科评分(REMS)以及序贯器官衰竭评分(SOFA)。比较患者预后情况,使用受试者工作特征曲线(ROC)分析三种评分方法对感染患者预后的预测价值。【结果】入住ICU 28 d内死亡29例,病死率为36.2%,存活51例(63.8%)。随着SOFA、qSOFA、REMS评分的增加,患者病死率增加。死亡组患者SOFA、qSOFA、REMS评分均高于存活组,且差异有显著性(P<0.05)。ROC曲线结果显示,SOFA评分预测病死率的AUC最大(0.741),其次为REMS和qSOFA评分;三种评分比较差异无显著性(P>0.05)。qSOFA评分约登指数确定的最佳截断值为2分,灵敏度为69.4%,特异度为68.5%,AUC为0.710。qSOFA≥2分组死亡风险较qSOFA<2分组显著升高(P<0.05)。【结论】SOFA、qSOFA、REMS评分均可预测ICU感染患者病死率,qSOFA作为简单快捷的评分系统,能快速有效判断ICU感染患者病情严重程度和死亡情况。
【Objective】The predictive value of quick sequential organ failure assessment(qSOFA)in the prognosis of patients with ICU infection.【Methods】The clinical data of 80 infected patients admitted to ICU of our hospital were retrospectively analyzed.The qSOFA,rapid emergency departmental(REMS)score and sequential organ failure assessment score(SOFA)were calculated.The prognosis of infected patients was recorded.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of the three scoring methods for the prognosis of infected patients.【Results】A total of 29 deaths that occurred within 28 days among 80 ICU admissions showed the mortality rate was 36.2%and the survival rate was 63.8%(51/80).As the scores of SOFA,qSOFA,and REMS increase,the patient mortality rate increased.The scores of SOFA,qSOFA and REMS in the death group were higher than those in the survival group,the different was statistically significant(P<0.05).The ROC curve showed that among the three scores,the SOFA score predicted the highest AUC(0.741)of the mortality rate,followed by the REMS and qSOFA scores.However,there were no significant differences in AUC among the three scores(P>0.05).The optimal cutoff value for the qSOFA score was 2 points,which the sensitivity was 69.4%,the specificity was 68.5%,and the AUC was 0.710.The death risk in the qSOFA≥2 group was significantly higher than that in the qSOFA<2 group(P<0.05).【Conclusion】SOFA,qSOFA and REMS scores can predict the mortality of patients with ICU infection.We find that qSOFA is a simple and fast scoring system,which can quickly and effectively judge the severity and death of patients with ICU infection.
作者
丁国钰
葛兰
DING Guo-yu;GE Lan(Taizhou People's Hospital,Jiangsu Province,225300)
出处
《医学临床研究》
CAS
2019年第11期2160-2162,共3页
Journal of Clinical Research
关键词
重症监护病房
感染
交叉感染
预后
Intensive Care Units
Infection
Cross Infection
Prognosis
