血乳酸水平联合qSOFA评分对脓毒症患者预后情况的调查分析

Investigation and analysis of blood lactate levels combined with qSOFA scores on prognosis of patients with sepsis

目的研究脓毒症患者动脉血乳酸(LAC)水平与快速序贯器官衰竭评分(qSOFA)评分相关性,探讨患者LAC水平联合qSOFA评分对急诊脓毒症患者病预后情况判断的能力。方法选取2020年1月至2021年1月经盐城市第一人民医院急诊抢救室就诊的脓毒症患者83例,记录每例患者的LAC水平、qSOFA评分分值,比较患者LAC水平,qSOFA评分以及LAC水平联合qSOFA评分。结果①3种评分对28 d内患者死亡情况比较,差异有统计学意义(P<0.05)。②LAC水平联合qSOFA评分敏感度87.57%,特异度79.30%;qSOFA评分敏感度95.80%,特异度35.60%;LAC水平敏感度83.30%,特异度61.00%。③LAC水平联合qSOFA评分与qSOFA评分对脓毒症患者预后情况预测的ROC曲线下面积比较差异有统计学意义(P<0.05),与LAC水平对脓毒症患者预后情况预测的ROC曲线下面积比较,差异无统计学意义(P>0.05)。结论LAC水平联合qSOFA评分更够快速、准确地预测脓毒症患者的预后情况,可作为对qSOFA评分的补充。

【Objective】To study the correlation between arterial blood lactic acid(LAC)level and Quick Sequential Organ Failure Assessment(qSOFA)score,and explore the ability of LAC and qSOFA scores to determine the prognosis of emergency sepsis patients,so as to find a quick and accurate scoring tool and effective warning of critically ill patients.【Methods】Eightythree sepsis patients seen in the emergency room of Yancheng First People's Hospital from January 2020 to January 2021 were selected to record their LAC level,qSOFA score,and compare their LAC level,qSOFA score and LAC level combined with qSOFA score.【Results】①There were significant differences in the three scores for patient deaths within 28 days(P<0.05).②The sensitivity and specificity of LAC level combined with qSOFA score was 87.57%,79.30%;the sensitivity and specificity of qSOFA score was 95.80%,35.60%;the sensitivity and specificity of LAC level was 83.3%and 61.0%.③There was statistically significant difference in the area under the ROC curve between LAC level combined with qSOFA score and qSOFA score for predicting the prognosis of sepsis patients(P<0.05),but no statistically significant difference between LAC level combined with qSOFA score and LAC level for sepsis patients(P>0.05).【Conclusion】LAC level combined with qSOFA score is more rapid and accurate to predict the prognosis of sepsis patients,which can be used as a supplement to qSOFA score,and can be used for early rapid detection of critically ill patients in emergency rooms,to remind emergency department medical staff to strengthen attention,conduct predictive care,improve the quality of care,and ensure patient safety.