中文版的简化SOFA评分与qSOFA评分在脓毒症患者筛查中的价值比较研究  

The study on the value of using Chinese simlpe sequential organ failure assessment and quick sequential organ failure assessment for sepsis screening

作　　者：陈晓燕[1] 李元海[2] 汪正光 姚建华[1] Chen Xiao-yan;Li Yuan-hai;Wang Zheng-guang;Yao Jian-hua(Intensive Care Unit,Huangshan Shoukang Hospital,Huangshan 245000,China)

机构地区：[1]黄山首康医院重症医学科,安徽黄山245000 [2]安徽医科大学第一附属医院麻醉科,安徽合肥230022

出　　处：《中国急救医学》2019年第6期555-558,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的在简化序贯器官衰竭评分(simple sequential organ failure assessment, sSOFA)基础上建立一种新的脓毒症快速筛查评分,即中文版的sSOFA(Chinese sSOFA,C-sSOFA)评分,为早期发现脓毒症患者提供参考。方法选取2014年6月至2018年8月间在安徽黄山首康医院重症医学科(ICU)住院的209例患者做回顾性分析,其中脓毒症组107例,非脓毒症组102例。对每一例患者进行C-sSOFA评分和快速序贯器官衰竭(quick sequential organ failure assessment, qSOFA)评分,利用受试者工作特征(ROC)曲线比较两种评分在筛查脓毒症患者中的价值。结果 C-sSOFA评分和qSOFA评分筛查脓毒症患者的敏感度、特异度、阳性预测值、阴性预测值和Kappa值分别为89.70% vs.38.30%、54.50% vs.92.20%、68.1% vs.83.7%、83.1% vs.58.8%和0.45 vs.0.30。C-sSOFA评分筛查脓毒症患者的ROC曲线下面积0.721(95%CI0.650~0.793,P<0.001)。qSOFA评分筛查脓毒症患者的ROC曲线下面积0.651(95%CI0.576~0.726,P<0.001)。结论新的脓毒症快速筛查评分(C-sSOFA评分)对脓毒症患者的筛查效果优于qSOFA评分。Objective To establish a new rapid screening score for sepsis based on the simplified SOFA (simple sequential organ failure assessment,sSOFA) score,which is the simplified SOFA score (Chinese sSOFA,C-sSOFA score) in Chinese,and provide reference for early detection of sepsis patients.Methods A retrospective analysis was performed in 209 patients admitted to the department of critical care medicine (ICU) from June 2014 to August 2018 ,including 107 patients in the sepsis group and 102 patients in the non-sepsis group.Each patient was subjected to C-sSOFA score and quick sequential organ failure assessment (qSOFA) score,and the receiver operating characteristic (ROC) curve was used to compare the value of the two scores in screening patients with sepsis.Results The sensitivity,specificity,positive prediction value,negative prediction value and Kappa value of C-sSOFA score and qSOFA score in screening patients with sepsis were 89.70% vs.38.30%,54.50% vs.92.20%,68.1% vs.83.7%,83.1% vs.58.8% and 0.45 vs.0.30,respectively.The area under the ROC curve of C-sSOFA score and qSOFA score were 0.721 (95% Cl 0.650-0.793 ,P< 0.001) and 0.651 (95% CI 0.576-0.726,P < 0.001),respectively.Conclusion The new rapid screening score for sepsis,C-sSOFA score is better than qSOFA score in screening patients with sepsis.

关 键 词：脓毒症 评分 筛查 简化序贯器官衰竭评分(sSOFA) 快速序贯器官衰竭评分(qSOFA) 

分 类 号：R459.7[医药卫生—急诊医学]