快速序贯器官衰竭评分和英国早期预警评分对ICU脓毒症患者预后评估价值的比较

Comparative analysis of quick sequential organ failure assessment and national early warning score in prognosis of patients with sepsis

摘要:

目的 探讨快速序贯器官衰竭评分（qSOFA）和英国早期预警评分（NEWS）对ICU脓毒症患者病情及预后评估的临床价值。方法 回顾性分析2017年1月—2018年1月沈阳医学院附属中心医院ICU的成人脓毒症患者101例临床资料，分别进行qSOFA和NEWS评分，比较存活组和死亡组qSOFA和NEWS评分的区别。结果 死亡组与存活组比较，入ICU时休克患者例数比较差异有统计学意义（P?<0.05），脑血管病后遗症及糖尿病病史差异无统计学意义（P?>0.05）；患者的qSOFA评分和NEWS评分呈正相关（rs=0.680，P?= 0.000）；死亡组qSOFA评分和NEWS评分均高于存活组（P?<0.05）；60岁以上患者中死亡组qSOFA评分高于存活组（P?<0.05）；60～74岁患者中死亡组NEWS评分高于存活组（P?<0.05）；qSOFA评分和NEWS评分对死亡预测的ROC曲线下面积（AUC）分别为0.729和0.661，qSOFA评分预测死亡的敏感性为45.2%、特异性为95.7%、95% CI：（0.613，0.846），NEWS评分预测死亡的敏感性为58.1%、特异性为74.3%、95% CI：（0.531，0.791）。结论 qSOFA评分对ICU脓毒症患者预后的评估上优于NEWS评分，qSOFA评分分值越高，提示患者病情越危重。

Abstract:

Objective To compare the prognostic value of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score (NEWS) in patients with sepsis in intensive care unit. Methods A total of 101 adult patients with sepsis in ICU were retrospectively involved in this study. QSOFA score and NEWS were recorded. Results The ratio of shock patients in death group was significantly higher than that in survival group (P?< 0.05). There was no significant difference between two groups in the history of cerebrovascular disease and diabetes (P?>?0.05). A positive correlation between qSOFA and NEWS was identified (rs?=?0.680, P?=?0.000). The qSOFA and NEWS score in death group were higher than survival group significantly (P?