SOFA qSOFA MEWS和SIRS四种危险评分对急诊监护室疑似感染患者28d死亡的评估价值比较研究

Comparison of SOFA qSOFA MEWS and SIRS four risk scores in evaluating the 28-day mortality of patients with suspected infection in EICU

目的比较序贯器官衰竭评分(sepsis-related organ failure assessment,SOFA)、快速序贯器官衰竭评分(quick sepsis-related organ failure assessment,qSOFA)、改良早期预警评分(modified earl ywarning score,MEWS)和全身炎症反应综合征评分(systemic inflammatory response syndrome,SIRS)对急诊监护室(emergent intensive care unit,EICU)疑似感染患者28 d死亡的预测价值.方法前瞻性队列研究法对在2017年2月至2018年3月期间我院EICU疑似感染患者进行观察.记录临床资料和上述四种评分,随访入EICU 28 d的全因死亡.结果纳入研究的163例疑似感染患者,28d随访中死亡51例(31%).四种评分的曲线下面积(area under curve,AUC)分别为0.782(95% CI 0.711~0.843)、0.704(95% CI 0.628~0.773)、0.640(95% CI 0.562~0.714)和0.516(95% CI 0.436~0.595).结论SOFA评分对EICU疑似感染患者28 d死亡的预测能力最好.

Objective To analyze the predictive value of sepsis-related organ failure assessment(SOFA)score,quick sepsis-related organ failure assessment(qSOFA)score,modified early warning score(MEWS)and systemic inflammatory response syndrome(SIRS)score for the patients with suspected infection in Emergency Intensive Care Unit(EICU)of our hospital.Methods A perspective cohort study was conducted in EICU from February 2017 to March 2018.Clinical data and four scores were recorded.The 28-day mortality of patients was followed up through Health Insurance Information Management System and phone.Results A total of 163 patients with suspected infection in EICU were enrolled,51 cases(31%)were died.The areas under the curve(AUC)for four scores were respectively:0.782(95% CI 0.711-0.843),0.704(95% CI O.628-0.773),0.640(95% CI 0.562-0.714),0.516(95% CI 0.436-0.595).Conclusion SOFA score is the best to predict the prognosis of patients with suspected infection in EICU in 28 days.