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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
- 77 - 83 (7page)
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초록· 키워드
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Objective To test the hypothesis that the quick Sepsis-related Organ Failure Assessment (qSOFA) score, derived from vital signs taken during triage and recommended by current sepsis guidelines for screening patients with infections for organ dysfunction, is not sensitive enough to predict the risk of mortality in emergency department (ED) sepsis patients. Methods Patients diagnosed with severe sepsis and septic shock using the old definition between May 2014 and April 2015 were retrospectively reviewed in three urban tertiary hospital EDs. The sensitivities of systemic inflammatory response syndrome (SIRS) criteria, qSOFA, and Sequential Organ Failure Assessment (SOFA) scores ≥2 were compared using McNemar’s test. Diagnostic performances were evaluated using specificity, positive predictive value, and negative predictive value. Results Among the 928 patients diagnosed with severe sepsis or septic shock using the old definition, 231 (24.9%) died within 28 days. More than half of the sepsis patients (493/928, 53.1%) and more than one-third of the mortality cases (88/231, 38.1%) had a qSOFA score <2. The sensitivity of a qSOFA score ≥2 was 61.9%, which was significantly lower than the sensitivity of SIRS ≥2 (82.7%, P<0.001) and SOFA ≥2 (99.1%, P<0.001). The specificity, positive predictive value, and negative predictive value of a qSOFA score ≥2 for 28-day mortality were 58.1%, 32.9%, and 82.2%, respectively. Conclusion The current clinical criteria of the qSOFA are less sensitive than the SIRS assessment and SOFA to predict 28-day mortality in ED patients with sepsis.
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참고문헌 (15)
참고문헌 신청
Angus DC / 2001 / Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care / Crit Care Med 29:1303~1310
Dellinger RP / 2013 / Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012 / Crit Care Med 41:580~637
Bone RC / 1992 / Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine / Chest 101:1644~1655
Levy MM / 2003 / 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference / Crit Care Med 31:1250~1256
Churpek MM / 2015 / Incidence and prognostic value of the systemic inflammatory response syndrome and organ dysfunctions in ward patients / Am J Respir Crit Care Med 192:958~964
Dellinger RP / 2013 / Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012 / Crit Care Med 41:580~637
Bone RC / 1992 / Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine / Chest 101:1644~1655
Levy MM / 2003 / 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference / Crit Care Med 31:1250~1256
Churpek MM / 2015 / Incidence and prognostic value of the systemic inflammatory response syndrome and organ dysfunctions in ward patients / Am J Respir Crit Care Med 192:958~964
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