qSOFA评分联合休克指数评估脓毒症患者预后的价值  

Evaluation of the prognostic value of qSOFA score combined with shock index in patients with sepsis

作　　者：陈卫 石齐芳 陈嵩[2] 章冰玉 杨光耀 盛鹰 徐英 CHEN Wei;SHI Qifang;CHEN Song;ZHANG Bingyu;YANG Guangyao;SHENG Ying;XU Ying(Department of Emergency and Intensive Care Unit,Shanghai Pudong Hospitai,Shanghai,201399,China;Department of Emergency and Intensive Care Unit,Shanghai Pudong New Area People's Hospital;Department of Emergency,Gongli Hospital Affiliated to Naval Medical University)

机构地区：[1]上海市浦东医院急危重症医学科,上海201399 [2]上海市浦东新区人民医院急诊与重症医学科 [3]海军军医大学附属公利医院急诊医学科

出　　处：《临床急诊杂志》2023年第3期126-130,共5页Journal of Clinical Emergency

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划(No:PWRq2021-25);复旦大学附属浦东医院重点专科专病诊治中心项目资助(No:Tszb2021-04)。

摘　　要：目的:探讨快速序贯器官衰竭(qSOFA)评分联合休克指数(SI)在预测脓毒症患者预后的价值。方法:回顾性队列研究,收集3家区域医疗中心收治的306例脓毒症患者的临床资料,根据患者住院期间生存状态分存活组和死亡组,使用受试者工作曲线下面积(AUC)和决策曲线分析(DCA)评价qSOFA评分联合SI评估患者预后的价值。结果:SI与乳酸呈正相关(r=0.465,P<0.001)。SI的最佳截断值为1.0,SI≥1.0为1分,联合qSOFA评分形成SqSOFA评分,其预测患者的预后AUC是0.694(95%CI:0.639~0.745),优于qSOFA评分0.631(95%CI:0.574~0.685),差异有统计学意义(Z=3.867,P<0.001),决策曲线分析显示SqSOFA评分具有较好的临床应用效能。结论:qSOFA评分联合SI评估脓毒症患者住院病死率有一定价值。Objective: To explore the value of qSOFA score combined with shock index(SI) in predicting the prognosis of sepsis patients. Methods: A retrospective cohort study from three regional medical centers collected clinical data of 306 sepsis patients, followed up the patients’ survival status during hospitalization and divided them into a survival group and a death group. Assessing the efficacy of the combined qSOFA score and SI in predicting patient prognosis using the area under the receiver operating curve(AUC) and decision curve analysis(DCA). Results: SI was positively correlated with lactate(r=0.465, P<0.001). The optimal cut-off value for SI was 1.0, and a SI ≥1.0 was 1 point combined with the qSOFA score to form the SqSOFA score. AUC of SqSOFA score was 0.694(95%CI: 0.639-0.745), which was better than qSOFA score of 0.631(95%CI: 0.574-0.685), and the difference was statistically significant(Z=3.867, P<0.001). Decision curve analysis showed that SqSOFA had high clinical benefit in the test group. Conclusion: qSOFA score combined with SI has a certain value in predicting in-hospital mortality in sepsis patients.

关 键 词：脓毒症 评分 休克指数 快速序贯器官衰竭评分 

分 类 号：R631.2[医药卫生—外科学]