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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.6 No.1
- 발행연도
- 2019.1
- 수록면
- 1 - 8 (8page)
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초록· 키워드
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Objective Community-acquired pneumonia (CAP) is a major cause of sepsis, and sepsis-related acute organ dysfunction affects patient mortality. Although the quick Sequential Organ Failure Assessment (qSOFA) is a new screening tool for patients with suspected infection, its predictive value for the mortality of patients with CAP has not been validated. Lactate concentration is a valuable biomarker for critically ill patients. Thus, we investigated the predictive value of qSOFA with lactate concentration for in-hospital mortality in patients with CAP in the emergency department (ED). Methods From January 2015 to June 2015, 443 patients, who were diagnosed with CAP in the ED, were retrospectively analyzed. We defined high qSOFA or lactate concentrations as a qSOFA score ≥2 or a lactate concentration >2 mmol/L upon admission at the ED. The primary outcome was all-cause in-hospital mortality. Results Among the 443 patients, 44 (9.9%) died. Based on the receiver operating characteristic (ROC) analysis, the areas under the curves for the prediction of mortality were 0.720, 0.652, and 0.686 for qSOFA, CURB-65 (confusion, urea, respiratory rate, blood pressure, and age), and Pneumonia Severity Index, respectively. The area under the ROC curve of qSOFA was lower than that of SOFA (0.720 vs. 0.845, P=0.004). However, the area under the ROC curve of qSOFA with lactate concentration was not significantly different from that of SOFA (0.828 vs. 0.845, P=0.509). The sensitivity and specificity of qSOFA with lactate concentration were 71.4% and 83.2%, respectively. Conclusion qSOFA with lactate concentration is a useful and practical tool for the early prediction of in-hospital mortality among patients with CAP in the ED.
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참고문헌 (24)
참고문헌 신청
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Fine MJ / 1997 / A prediction rule to identify low-risk patients with community-acquired pneumonia / N Engl J Med 336:243~250
Lim WS / 2003 / Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study / Thorax 58:377~382
Singer M / 2016 / The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) / JAMA 315:801~810
Seymour CW / 2016 / Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) / JAMA 315:762~774
Fine MJ / 1997 / A prediction rule to identify low-risk patients with community-acquired pneumonia / N Engl J Med 336:243~250
Lim WS / 2003 / Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study / Thorax 58:377~382
Singer M / 2016 / The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) / JAMA 315:801~810
Seymour CW / 2016 / Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) / JAMA 315:762~774
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