改良qSOFA评分对重度烧伤患者预后的预测价值

Predictive value of the improved qSOFA score in severe burn patients

目的分析可改善重度烧伤患者快速序贯器官衰竭评估(qSOFA)评分系统的独立危险因素并探讨改良qSOFA评分对重度烧伤患者预后的预测价值.方法回顾分析烧伤科救治的重度烧伤患者,根据临床结局分为死亡组和康复组,并比较入院时各种预测评分的预测值.结果入选481例患者,影响病死率的独立危险因素为烧伤面积、乳酸和白蛋白,改良qSOFA评分结合了qSOFA评分、乳酸和白蛋白,其预测病死率的曲线下面积(AUC)为0.866(95%CI:0.808~0.924),最佳临界点为3分,其敏感度为77.8%,特异度为82.0%,其诊断性能优于qSOFA评分,但与改良Baux评分差异无统计学意义(P>0.05).结论改良qSOFA评分能预测重度烧伤患者的预后,有一定的临床意义.

Objective This study the independent risk factors that can improve the qSOFA scoring system in severe burn patients,and to explore the predictive value of the improved qSOFA score in patients with severe burns.Methods The severe burn patients treated in the Burn Department of Guangzhou Red Cross Hospital within 10 years were reviewed and analyzed.They were divided into death group and rehabilitation group according to the clinical outcomes,and the predictive values of various prediction scores at admission were compared.Results A total of 481 patients were selected,and the independent risk factors were burn area,lactate and albumin.The AUC of the improved qSOFA score combined qSOFA score,lactate and albumin,was 0.866(95%CI:0.808-0.924),which was better than qSOFA score,but was with no significantly different from the improved Baux score.With the cut-off score of 3 points,the sensitivity was 77.8%and the specificity was 82.0%.Conclusion The improved qSOFA score can predict the prognosis of severe burn patients with certain clinical significance.