qSOFA联合SIRS评分对急诊脓毒症的早期诊断效能分析

被引：8

作者：

庾胜 ^{[1
]}

张碧波 ^{[1
]}

顾晓蕾 ^{[1
]}

金钧 ^{[2
]}

机构：

[1] 常熟市第二人民医院

[2] 苏州大学附属第一医院

来源：

山东医药 | 2019年 / 59卷 / 20期

关键词：

脓毒症; 快速序贯器官功能衰竭评估; 全身炎症反应综合征;

D O I：

暂无

中图分类号：

R459.7 [急症、急救处理];

学科分类号：

100218 ;

摘要：

目的探讨快速序贯器官功能衰竭评估(qSOFA)评分联合全身炎症反应综合征(SIRS)评分对急诊脓毒症早期诊断的价值。方法选择在急诊抢救室就诊的506例疑似感染患者纳入研究。根据Sepsis3.0诊断标准将患者分为脓毒症组295例及非脓毒症组211例。对所有患者进行qSOFA、SIRS评分。采用ROC曲线分析qSOFA、SIRS评分单项应用及联合应用对脓毒症的诊断价值。结果脓毒症组qSOFA评分、SIRS评分均高于非脓毒症组(P均<0.05)。ROC曲线分析显示,qSOFA评分诊断脓毒症的截断值为1.5分,SIRS评分诊断脓毒症的截断值为2.5分。当qSOFA≥1及SIRS≥2时,诊断脓毒症的敏感度为84%、特异度为53%;当qSOFA≥2及SIRS≥2时,诊断脓毒症的特异度为97%、敏感度为32%。结论单独使用qSOFA或SIRS评分对脓毒症的诊断价值有限,两者联合应用更具有指导意义。当qSOFA≥2且SIRS≥2时需高度考虑脓毒症;当qSOFA≥1且SIRS≥2时,需动态观察,及时排查相关感染证据,避免漏诊。

引用

页码：86 / 89

页数：4

共 11 条

[1] A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality[J] . Rodrigo Serafim,José Andrade Gomes,Jorge Salluh,Pedro Póvoa.Chest . 2018 (3)
[2] Low Accuracy of Positive qSOFA Criteria for Predicting 28-Day Mortality in Critically Ill Septic Patients During the Early Period After Emergency Department Presentation
Hwang, Sung Yeon
Jo, Ik Joon
Lee, Se Uk
Lee, Tae Rim
Yoon, Hee
Cha, Won Chul
Sim, Min Seob
Shin, Tae Gun
[J]. ANNALS OF EMERGENCY MEDICINE, 2018, 71 (01) : 1 - 9
[3] Quick sequential organ failure assessment compared to systemic inflammatory response syndrome for predicting sepsis in emergency department[J] . Hyun Kyung Park,Won Young Kim,Myung Chun Kim,Woong Jung,Byuk Sung Ko.Journal of Critical Care . 2017
[4] Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality – a prospective study of patients admitted with infection to the emergency department[J] . ?sa,Askim,Florentin Moser,Lise T. Gustad,Helga Stene,Maren Gundersen,Bj?rn Olav ?svold,Jostein Dale,Lars Petter Bj?rnsen,Jan Kristian Dam?s,Erik Sollig?rd.Scandinavian Journal of Trauma, Resuscitation and . 2017 (1)
[5] Quick Sequential Organ Failure Assessment and Systemic Inflammatory Response Syndrome Criteria as Predictors of Critical Care Intervention Among Patients With Suspected Infection*[J] . Ari Moskowitz,Parth V. Patel,Anne V. Grossestreuer,Maureen Chase,Nathan I. Shapiro,Katherine Berg,Michael N. Cocchi,Mathias J. Holmberg,Michael W. Donnino.Critical Care Medicine . 2017 (11)
[6] A comparison of pre ICU admission SIRS, EWS and q SOFA scores for predicting mortality and length of stay in ICU[J] . Shahla Siddiqui,Maureen Chua,Venkatesan Kumaresh,Robin Choo.Journal of Critical Care . 2017
[7] Risk assessment of the blunt trauma victim: The role of the quick Sequential Organ Failure Assessment Score (qSOFA)[J] . Randeep S. Jawa,James A. Vosswinkel,Jane E. McCormack,Emily C. Huang,Henry C. Thode,Marc J. Shapiro,Adam J. Singer.The American Journal of Surgery . 2017 (3)
[8] New Sepsis and Septic Shock Definitions: Clinical Implications and Controversies[J] . Chanu Rhee,Michael Klompas.Infectious Disease Clinics of North America . 2017 (3)
[9] Potential Impact of the 2016 Consensus Definitions of Sepsis and Septic Shock on Future Sepsis Research[J] . Sandra L. Peake,Anthony Delaney,Michael Bailey,Rinaldo Bellomo,V. Bennett,J. Board,P. McCracken,S. McGloughlin,V. Nanjayya,A. Teo,E. Hill,P. Jones,E. O’Brien,F. Sawtell,K. Schimanski,D. Wilson,R. Bellomo,S. Bolch,G. Eastwood,F. Kerr,L. Peak,H. Young,J. Edington,J. Fletcher,J. Smith,D. Ghelani,K. Nand,T. Sara,A. Cross,D. Flemming,M. Grummisch,A. Purdue,E. Fulton,K. Grove,A. Harney,K. Milbu
[10] Comparison of qSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis[J] . Samir Haydar,Matthew Spanier,Patricia Weems,Samantha Wood,Tania Strout.American Journal of Emergency Medicine . 2017

← 1 2 →