快速序贯器官衰竭评估评分筛检颅内感染致脓毒症的效力评价

发布时间：2018-05-21 17:42

  本文选题：快速序贯器官衰竭评估评分 + qSOFA　； 参考：《西部医学》2016年12期

【摘要】：目的评估简单快速易获得的快速序贯器官衰竭评估(quick Sequential Organ Failure Assessment,qSOFA)评分能否有效筛检颅内感染性疾病所致的脓毒症。方法采用回顾性横断面研究方法,收集2016年1月1日~2016年5月31日期间在四川大学华西医院急诊科就诊的颅内感染性疾病病例,按照最新的脓毒症诊断标准Sepsis3.0,将其分为脓毒症组及非脓毒症组。比较两组间一般资料与qSOFA评分有无差异,以ROC曲线评估qSOFA筛查颅内感染性疾病所致脓毒症患者的效力。结果纳入颅内感染性疾病患者186例,其中脓毒症组108例(58.1%),非脓毒症组78例(41.9%),脓毒症组的qSOFA值明显高于非脓毒症组(P0.01)。当以qSOFA值2为截断值时,对颅内感染性疾病致脓毒症初筛的敏感度仅为39.8%,特异度为98.7%,阳性预测值(PPV)为97.7%,阴性预测值(NPV)为54.2%;以q SOFA值1为截断值,qSOFA对颅内感染性疾病所致脓毒症初筛的敏感度为88.0%,特异度为75.6%,PPV为83.3%,NPV为82.0%。结论颅内感染所致脓毒症的发病率为58.1%,脓毒症组的qSOFA值明显高于非脓毒症组,可以考虑使用qSOFA值作为早期筛查颅内感染所致脓毒症的工具;qSOFA≥1筛检颅内感染性疾病所致脓毒症的效力比qSOFA≥2高,是否将qSOFA≥2作为筛检颅内感染性疾病所致脓毒症还需要进一步研究。
[Abstract]:Objective to evaluate the effectiveness of rapid Sequential Organ Failure assessment QSOFAA score in the screening of sepsis caused by intracranial infectious diseases. Methods A retrospective cross-sectional study was conducted to collect cases of intracranial infectious diseases from January 1, 2016 to May 31, 2016 in the Department of Emergency, Huaxi Hospital, Sichuan University. Sepsis 3.0, the latest diagnostic criteria for sepsis, was divided into sepsis group and non sepsis group. To compare the difference of general data and qSOFA score between the two groups, the effectiveness of qSOFA in the screening of patients with sepsis caused by intracranial infectious diseases was evaluated by ROC curve. Results 186 patients with intracranial infectious diseases were included, including 108 patients with sepsis (n = 108) and 78 patients with non-sepsis (n = 78). The qSOFA value of sepsis group was significantly higher than that of non-sepsis group (P 0.01). When the qSOFA value 2 is truncated, The sensitivity, specificity, positive predictive value and negative predictive value of primary screening for sepsis caused by intracranial infectious diseases were only 39.8, 98.7, 97.7 and 54.2 respectively. The specificity was 75.6 and the PPV was 83.3 and the NPV was 82.0. Conclusion the incidence of sepsis caused by intracranial infection is 58.1. The qSOFA value of sepsis group is significantly higher than that of non-sepsis group. We may consider using qSOFA value as an early tool for screening sepsis caused by intracranial infection. QSOFA 鈮，

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