CURB-65 qSOFA评分对社区获得性肺炎患者的预后预测价值  

Value of qSOFA and CURB-65 scores for prognosis prediction in patients with emergency community-acquired pneumonia

作　　者：梁培培[1] 俞风 LIANG Peipei;YU Feng(Department of Emergency Intensive Care Unit,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院急诊ICU,合肥230022

出　　处：《安徽医学》2021年第2期139-143,共5页Anhui Medical Journal

基　　金：安徽省临床医学应用项目(项目编号:08B063)。

摘　　要：目的探讨qSOFA、CURB-65评分对社区获得性肺炎(CAP)患者的预后预测价值。方法选择2016年6月至2019年10月安徽医科大学第一附属医院急诊门诊收住院的312例社区CAP患者。根据住院治疗结局,分为非死亡(n=262)与死亡组(n=50);根据2016年版中国成人CAP诊断与治疗指南中CAP诊断及分级标准,分为重症CAP组(n=109)与非重症CAP组(n=203)。以重症CAP和死亡作为不良预后指标,采用受试者工作特征曲线分析qSOFA、CURB-65评分对不良预后的预测效能,并对qSOFA评分量表进行改良,优化预测效能。结果qSOFA评分、CURB-65评分和Age-Lac-qSOFA评分预测死亡的曲线下面积(AUC)分别为0.856、0.860和0.956,特异度分别为92.00%、97.04%和91.52%,灵敏度分别为49.80%、38.14%和83.45%。预测重症CAP的AUC分别为0.835、0.846和0.958,特异度分别为89.80%、83.24%和97.15%,灵敏度分别为58.14%、70.30%和79.89%。结论CURB-65评分与qSOFA评分对急诊重症CAP及死亡预后预测价值相仿。优化调整后Age-Lac-qSOFA评分,提高了对重症CAP及死亡预后的预测效能,且具有更高的灵敏度。Objective To investigate the clinical values of qSOFA and CURB-65 scores in predicting the prognosis of community-acquired pneumonia patients in the emergency department.Methods A total of 312 community-acquired pneumonia patients were selected from the Emergency Department of our hospital from June 2016 to October 2019.According to the outcome of hospitalization,they were divided into thenon-death group(262 cases)and the death group(50 cases);the severe community acquired pneumonia group(109 cases)and the non-severe community acquired pneumonia group(203 cases),according to the severity of pneumonia.Using severe CAP and death as poor prognostic indicators,the predictive efficacy of qSOFA and CURB-65 scores was analyzed by receiver operating characteristic curve,and the predictive performance of qSOFA scoring scale was imp roved and optimized.Results The predicted AUC values of qSOFA score,CURB-65 score and Age-Lac-qSOFA score was 0.856,0.860 and 0.956,respectively,their specificity was 92.00%,97.04%and 91.52%,respectively,and the sensitivity was 49.80%,38.14%and 83.45%,respectively.The predicted AUC value of severe CAP was 0.835,0.846 and 0.958,respectively,the specificity was 89.80%,83.24%and 97.15%,respectively,and the sensitivity was 58.14%,70.30%and 79.89%,respectively.Conclusions There is no statistical difference in comparing CURB-65 score and qSOFA score in emergency severe CAP and death prognosis prediction.The optimized Age-Lac-qSOFA score improves the prediction efficiency of severe CAP and death prognosis with higher sensitivity.

关 键 词：急诊社区获得性肺炎 预后 qSOFA评分 CURB-65评分 

分 类 号：R563.1[医药卫生—呼吸系统]