摘要
目的:评价电子序贯器官衰竭评估（eSOFA）、快速序贯器官衰竭评估（qSOFA）及全身炎症反应综合征（SIRS）评分系统在非ICU环境中预测脓毒症患者预后的价值。方法:前瞻性分析2016年10月至2017年3月收治于北京协和医院10个非ICU病区的脓毒症患者，以入院后28 d患者临床结局作为预后指标，计算入组患者eSOFA、qSOFA及SIRS评分，使用受试者工作特征曲线（ROC）评价eSOFA、qSOFA及SIRS评分预测患者预后的能力。结果:研究期间共193例符合Sepsis-3脓毒症诊断标准。eSOFA、qSOFA及SIRS评分预测脓毒症患者预后的ROC的曲线下面积（AUC）分别为0.766（95%CI：0.700~0.824），0.798（95%CI：0.700~0.896），0.589（95%CI：0.475~0.703）。其中qSOFA预测效能最佳，但与eSOFA比较差异无统计学意义，SIRS预测效能最差。结论:非ICU环境下，qSOFA对脓毒症患者预后的预测效能最佳，eSOFA次之，SIRS最差。
Abstract
Objective:To evaluate the value of electric sequential organ failure assessment (eSOFA), quick sequential organ failure assessment (qSOFA) and system inflammatory reaction syndrome (SIRS) scoring system in predicting the prognosis of patients with sepsis in the non-ICU environment.Methods:Patients with sepsis in 10 non-ICU wards of Peking Union Medical College Hospital from October 2016 to March 2017 were prospectively analyzed. The clinical outcome of survival status 28 days after admission was taken as the prognostic index. The eSOFA, qSOFA and SIRS scores of the patients were calculated and the ROC curve was used to evaluate the prognostic value of eSOFA, qSOFA and SIRS scores.Results:A total of 193 patients met the Sepsis-3 diagnosis criteria. The AUROC of eSOFA, qSOFA and SIRS scores for predicting the prognosis of sepsis patients were 0.766 (95%CI: 0.700-0.824), 0.798 (95%CI: 0.700-0.896) and 0.589 (95%CI: 0.475-0.703) respectively. Among them, qSOFA had the best predictive performance, and both of qSOFA and eSOFA were better than SIRS.Conclusion:In non-ICU wards, qSOFA performed best in predicting prognosis of sepsis patients, eSOFA is the next and SIRS is the worst.
基金项目
中国医学科学院医学与健康科技创新工程(2021-I2M-1-062)
国家重点研发计划项目(2022YFC2304601)
万方数据