SOFA评分、qSOFA评分和SIRS评分对脓毒症患者病死率的预测价值分析  

Analysis of the value of SOFA,qSOFA and SIRS score in predicting mortality in patients with sepsis

作　　者：林菊 姚白雪 林乐清[1] 王辉[1] 景云烟 王磊[1] LIN Ju;YAO Baixue;LIN Leqing;WANG Hui;JING Yunyan;WANG Lei(Department of Intensive Care Medicine,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院重症医学科,310015

出　　处：《心电与循环》2023年第2期112-116,共5页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生科技计划项目(2020KY217、2022KY965);杭州市医药卫生科技项目(A20220419);杭州市医学重点学科建设项目(2021-21)。

摘　　要：目的探讨序贯器官衰竭评估(SOFA)评分、快速序贯器官衰竭评估(qSOFA)评分及全身炎症反应综合征(SIRS)评分对脓毒症患者病死率的预测价值。方法选择2019年1月至2020年2月杭州师范大学附属医院重症监护室(ICU)收治的急性感染患者80例,根据是否最终诊断为脓毒症分为观察组和对照组,其中观察组患者再根据预后分为存活亚组和死亡亚组。入ICU 24 h内进行SOFA评分、qSOFA评分和SIRS评分。比较SOFA评分、qSOFA评分和SIRS评分对脓毒症患者病死率的预测价值。结果观察组患者SOFA评分、qSOFA评分和SIRS评分均高于对照组,差异均有统计学意义(均P<0.05)。存活亚组患者来源急诊比例高于死亡亚组,合并症个数、SOFA评分、qSOFA评分和SIRS评分低于死亡亚组,差异均有统计学意义(均P<0.05)。在预测脓毒症病死率上,SOFA评分的AUC、灵敏度及特异度最高,qSOFA评分次之,SIRS评分最低,差异均有统计学意义(均P<0.05)。结论相较于qSOFA评分和SIRS评分,SOFA评分在预测ICU脓毒症病死率方面更具优势。Objective To evaluate the ability of sequential organ failure assessment(SOFA)score,quick Sequential Organ Failure Assessment(qSOFA)score and systemic inflammatory response syndrome(SIRS)score in predicting mortality in patients with sepsis.Methods Eighty patients with acute infection admitted to the intensive care unit(ICU)of the Affiliated Hospital of Hangzhou Normal University from January 2019 to February 2020 were selected and divided into observation and control groups according to whether sepsis was determined finally.The patients in the observation group were divided into survival and death subgroups according to their prognosis.SOFA score,qSOFA score and SIRS score were calculated within 24 hours of admission to ICU.The predictive value of SOFA score,qSOFA score and SIRS score on the mortality of patients with sepsis was compared.Results SOFA score,qSOFA score and SIRS score were significantly higher in the observation group than in the control group(all P<0.05).The proportion of patients in emergency admission was significantly higher,complications,SOFA score,qSOFA score and SIRS score were significantly lower in survival subgroup than in death subgroup(all P<0.05).In the prediction of sepsis mortality,the area under the curve,the sensitivity and specificity were the highest for SOFA score,second for qSOFA score and the lowest for SIRS score with significantly different between different scores(all P<0.05).Conclusion SOFA score has more advantages than qSOFA score and SIRS score in predicting mortality of ICU sepsis.

关 键 词：序贯器官衰竭评估 感染 脓毒症 病死率 

分 类 号：R459.7[医药卫生—急诊医学]