四种病情评分方法对急诊感染患者预后的预测价值比较  

Value of four scoring systems in prediction of prognosis of patients with emergency infection

作　　者：余壁湘[1] 潘春球[1] 吕明花[2] 王赞智[1] 赖俊梅[1] YU Bi-xiang;PAN Chun-qiu;LYU Ming-hua;WANG Zan-zhi;LAI Jun-mei(Southern Hospital of Southern Medical University,Guangzhou,Guangdong 510515,China)

机构地区：[1]南方医科大学南方医院急诊科,广东广州510515 [2]南方医科大学珠江医院肾内科,广东广州510282

出　　处：《中华医院感染学杂志》2020年第17期2652-2656,共5页Chinese Journal of Nosocomiology

基　　金：南方医科大学南方医院基金资助项目(CX2018N013);南方医科大学南方医院基金资助项目(2016B012)。

摘　　要：目的 分析快速序贯器官衰竭估计(qSOFA)评分、序贯器官衰竭估计(SOFA)评分、早期预警(NEWS)评分及全身炎症反应综合征(SIRS)评分对急诊感染患者预后的预测价值.方法 回顾性分析2016年10月-2019年10月南方医科大学南方医院收治的100例感染性疾病患者临床资料,依据28 d预后情况将其分为研究组(28 d内死亡)21例和对照组(28 d内存活)79例,分析两组患者一般资料、生命体征及入院24 h内qSOFA评分、SOFA评分、NEWS评分、SIRS评分情况,绘制受试者工作特征曲线(ROC)分析qSOFA评分、SOFA评分、NEWS评分及SIRS评分对急诊感染患者预后的预测价值.结果 研究组患者年龄、心率、动脉血乳酸、脑钠肽前体、白细胞计数、血小板计数、血肌酐均高于对照组(P<0.05),平均动脉压、格拉斯哥昏迷评分、动脉血氧分压、氧合指数均低于对照组(P<0.05);研究组患者入院24 h内平均qSOFA评分、SOFA评分、NEWS评分及SIRS评分均高于对照组(P<0.05);ROC曲线分析显示,qSOFA评分预测急诊感染患者死亡的曲线下面积为0.83,高于SOFA评分(0.73)、NEWS评分(0.75)及SIRS评分(0.73),且qSOFA评分的灵敏度、特异度、准确度也较其他3种评分高.结论 qSOFA评分、SOFA评分、NEWS评分及SIRS评分均对急诊感染患者预后有预测价值,其中qSOFA评分预测价值最佳,有望成为评估急诊感染患者病情与预后的快捷简便工具.OBJECTIVE To analyze the value of quick sequential organ failure assessment score(qSOFA score),sequential organ failure assessment score(SOFA score),national early warning score(NEWS)and systemic inflammatory response syndrome score(SIRS score)in prediction of prognosis of patients with emergency infection.METHODS The clinical data of 100 patients with infectious diseases who were admitted to the Southern Hospital of Southern Medical University hospital from Oct 2016 to Oct 2019 were retrospectively analyzed.According to 28-day prognosis,they were divided into the study group(died within 28 days)and the control group(survived within 28 days).The general data and vital signs as well as qSOFA score,SOFA score,NEWS and SIRS score within 24 hours after admission were observed.The receiver operating characteristic(ROC)curves were drawn to analyze the value of qSOFA,SOFA,NEWS and SIRS scores in prediction of the prognosis of the patients with emergency infection.RESULTS The age,heart rate,arterial blood lactate,brain natriuretic peptide,white blood cell count,platelet count and serum creatinine of the study group were significantly higher than those of the control group(P<0.05)while the mean arterial pressure,score of Glasgow Coma Scale,arterial oxygen partial pressure and oxygenation index of the study group were significantly lower than those of the control group(P<0.05).The average qSOFA score,SOFA score,NEWS and SIRS score of the study group were significantly higher than those of the control group within 24 h after admission(P<0.05).ROC curve analysis showed that area under the curve(AUC)of qSOFA score was 0.830 in prediction of death of the patients with emergency infection,higher than 0.73 of SOFA,0.75 of NEWS,0.73 of SIRS score.The sensitivity,specificity and accuracy of qSOFA score were higher than those of the other three.CONCLUSION The qSOFA score,SOFA score,NEWS and SIRS score have the value in prediction of the prognosis of the patients with emergency infection,and the qSOFA score has the highest predictiv

关 键 词：qSOFA评分 SOFA评分 NEWS评分 SIRS评分 急诊感染 预后 预测价值 

分 类 号：R44[医药卫生—诊断学]