PDF(Pubmed)
Abstract：
UNASSIGNED: Various scores have been developed to predict sepsis mortality. This Study aimed to evaluate the accuracy of the quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS), National Early Warning Score (NEWS) and Ramathibodi Early Warning Score (REWS) for predicting severity and 28-day mortality of elderly suspected sepsis cases in emergency department (ED).
UNASSIGNED: This prognostic accuracy study was performed using data obtained from patients aged ≥ 60 years with suspected sepsis who visited the Ramathibodi Hospital ED between May and December 2019. The accuracy of NEWS, SIRS, REWS, and qSOFA in predicting the studied outcomes were evaluated using the receiver operating characteristic (ROC) curve analysis.
UNASSIGNED: A total of 531 cases with the mean age of 77.6 ± 9.39 (range: 60-101) years were evaluated (45% male). The overall 28-day mortality was 11.6%. The area under ROC curve of qSOFA scores ≥2 showed moderate discrimination (0.66, 95% confidence interval [CI]: 0.59-0.73) in predicting mortality, which was significantly higher than SIRS ≥2 (ROC: 0.56, 95% CI: 0.50-0.63; p=0.04), NEWS ≥5 (ROC: 0.56, 95% CI: 0.50-0.63; p=0.01), and REWS ≥4 (ROC: 0.56, 95% CI: 0.50-0.63; p<0.01).
UNASSIGNED: qSOFA score ≥2 was superior to SIRS ≥2, NEWS ≥5, and REWS ≥4 in predicting 28-day mortality and septic shock in elderly patients with suspected sepsis in the ED. However, the predictive performance of qSOFA ≥2 was only moderate (AUC<0.8). Therefore, to reduce mortality and improve outcomes, we suggest the use of qSOFA ≥2 combined with clinical or other early warning scores, or the development of new prediction scores for screening, triage, and prediction of mortality and of severity of sepsis in elderly patients with suspected sepsis in the ED.
UNASSIGNED: This prognostic accuracy study was performed using data obtained from patients aged ≥ 60 years with suspected sepsis who visited the Ramathibodi Hospital ED between May and December 2019. The accuracy of NEWS, SIRS, REWS, and qSOFA in predicting the studied outcomes were evaluated using the receiver operating characteristic (ROC) curve analysis.
UNASSIGNED: A total of 531 cases with the mean age of 77.6 ± 9.39 (range: 60-101) years were evaluated (45% male). The overall 28-day mortality was 11.6%. The area under ROC curve of qSOFA scores ≥2 showed moderate discrimination (0.66, 95% confidence interval [CI]: 0.59-0.73) in predicting mortality, which was significantly higher than SIRS ≥2 (ROC: 0.56, 95% CI: 0.50-0.63; p=0.04), NEWS ≥5 (ROC: 0.56, 95% CI: 0.50-0.63; p=0.01), and REWS ≥4 (ROC: 0.56, 95% CI: 0.50-0.63; p<0.01).
UNASSIGNED: qSOFA score ≥2 was superior to SIRS ≥2, NEWS ≥5, and REWS ≥4 in predicting 28-day mortality and septic shock in elderly patients with suspected sepsis in the ED. However, the predictive performance of qSOFA ≥2 was only moderate (AUC<0.8). Therefore, to reduce mortality and improve outcomes, we suggest the use of qSOFA ≥2 combined with clinical or other early warning scores, or the development of new prediction scores for screening, triage, and prediction of mortality and of severity of sepsis in elderly patients with suspected sepsis in the ED.
摘要：
■已经开发了各种评分来预测败血症死亡率。本研究旨在评估快速序贯器官衰竭评估(qSOFA)的准确性，全身炎症反应综合征(SIRS),国家早期预警评分（NEWS）和Ramathibodi早期预警评分（REWS）用于预测急诊科（ED）中老年可疑败血症病例的严重程度和28天死亡率。
这项预后准确性研究是使用从2019年5月至12月期间就诊于Ramathibodi医院ED的≥60岁疑似脓毒症患者获得的数据进行的。新闻的准确性，SIRS,REWS,使用受试者工作特征（ROC）曲线分析评估和qSOFA在预测研究结果方面的作用。
■总共评估了531例，平均年龄为77.6±9.39（范围：60-101）岁（男性占45％）。28天总死亡率为11.6%。qSOFA评分≥2的ROC曲线下面积在预测死亡率方面表现出中等程度的差异（0.66，95％置信区间[CI]：0.59-0.73）。显著高于SIRS≥2（ROC：0.56，95%CI：0.50-0.63；p=0.04），新闻≥5（ROC：0.56，95%CI：0.50-0.63；p=0.01），REWS≥4（ROC：0.56，95%CI：0.50-0.63；p<0.01）。
■qSOFA评分≥2优于SIRS≥2、NEWS≥5和REWS≥4，可预测ED中疑似脓毒症的老年患者的28天死亡率和感染性休克。然而,qSOFA≥2的预测性能仅为中等（AUC<0.8）。因此,为了降低死亡率和改善结果，我们建议使用qSOFA≥2结合临床或其他早期预警评分，或者开发新的筛查预测分数，分诊,并预测可疑脓毒症老年患者的死亡率和脓毒症严重程度。
这项预后准确性研究是使用从2019年5月至12月期间就诊于Ramathibodi医院ED的≥60岁疑似脓毒症患者获得的数据进行的。新闻的准确性，SIRS,REWS,使用受试者工作特征（ROC）曲线分析评估和qSOFA在预测研究结果方面的作用。
■总共评估了531例，平均年龄为77.6±9.39（范围：60-101）岁（男性占45％）。28天总死亡率为11.6%。qSOFA评分≥2的ROC曲线下面积在预测死亡率方面表现出中等程度的差异（0.66，95％置信区间[CI]：0.59-0.73）。显著高于SIRS≥2（ROC：0.56，95%CI：0.50-0.63；p=0.04），新闻≥5（ROC：0.56，95%CI：0.50-0.63；p=0.01），REWS≥4（ROC：0.56，95%CI：0.50-0.63；p<0.01）。
■qSOFA评分≥2优于SIRS≥2、NEWS≥5和REWS≥4，可预测ED中疑似脓毒症的老年患者的28天死亡率和感染性休克。然而,qSOFA≥2的预测性能仅为中等（AUC<0.8）。因此,为了降低死亡率和改善结果，我们建议使用qSOFA≥2结合临床或其他早期预警评分，或者开发新的筛查预测分数，分诊,并预测可疑脓毒症老年患者的死亡率和脓毒症严重程度。
