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Comparison of different versions of the quick sequential organ failure assessment for predicting in-hospital mortality of sepsis patients:A retrospective observational study

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World Journal of Emergency Medicine 2022年第2期13卷 114-119页

作者： Hai Hu Jing-yuan Jiang Ni Yao Emergency Office of West China Hospital Sichuan UniversityChengdu 610041China China International Emergency Medical Team Chengdu 610041China Emergency Department West China HospitalSichuan UniversityChengdu 610041China West China School of Nursing Sichuan UniversityChengdu 610041China Department of Critical Care Medicine West China HospitalSichuan UniversityChengdu 610041China

BACKGROUND:The quick sequential organ failure assessment(qSOFA)is recommended to identify sepsis and predict sepsis ***,some studies have recently shown its poor performance in sepsis mortality *** enhance its effectiveness,researchers have developed various revised versions of the qSOFA by adding other parameters,such as the lactate-enhanced qSOFA(LqSOFA),the procalcitonin-enhanced qSOFA(PqSOFA),and the modified qSOFA(MqSOFA).This study aimed to compare the performance of these versions of the qSOFA in predicting sepsis mortality in the emergency department(ED).METHODS:This retrospective study analyzed data obtained from an electronic register system of adult patients with sepsis between January 1 and December 31,*** operating characteristic(ROC)curve analyses were performed to determine the area under the curve(AUC),with sensitivity,specificity,and positive and negative predictive values calculated for the various ***:Among the 936 enrolled cases,there were 835 survivors and 101 *** AUCs of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 0.740,0.731,0.712,and 0.705,*** sensitivity of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 64.36%,51.40%,71.29%,and 39.60%,*** specificity of the four scores were 70.78%,80.96%,61.68%,and 91.62%,*** LqSOFA and MqSOFA were superior to the qSOFA in predicting in-hospital ***:Among patients with sepsis in the ED,the performance of the PqSOFA was similar to that of the qSOFA and the values of the LqSOFA and MqSOFA in predicting in-hospital mortality were greater compared to *** the added parameter of the MqSOFA was more convenient compared to the LqSOFA,the MqSOFA could be used as a candidate for the revised qSOFA to increase the performance of the early prediction of sepsis mortality.

关键词： quick sequential organ failure assessment In-hospital mortality Sepsis Lactate-enhanced qSOFA Modified qSOFA

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Contribution of quick sequential organ failure assessment Score Combined with Electrocardiography in Risk Stratification of Patients with Acute Pulmonary Embolism

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Chinese Medical Journal 2018年第20期131卷 2395-2401页

作者： Fei Teng Yun-Xia Chen Xin-Hua He Shu-Bin Guo Department of Emergency Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China Department of Infection and Microbiology Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China

Background： The quick sequential organ failure assessment （qSOFA） score emerged recently. We investigated its contribution to risk stratification in acute pulmonary embolism （PE） by combining with electrocardiography （ECG）. Methods： Acute PE patients diagnosed in Beijing Chao-Yang Hospital, Capital Medical University, from 2008 to 2018 were retrospectively studied and divided into high- and low-risk groups by imaging and biomarkers. The ECG scores consisted oftachycardia, McGinn-White sign （S1Q3T3）, right bundle branch block, and T-wave inversion of leads V1-V3. A new combination of qSOFA scores and ECG scores by logistic regression for predicting high-risk stratification patients with acute PE was evaluated by a receiver operating characteristic curve. Results： Totally 1318 patients were enrolled, including 271 in the high-risk group and 1047 in the low-risk group. A combination predictive scoring system named qSOFA-ECG = qSOFA score ＋ ECG score was created. The optimal cutoffvalue for qSOFA-ECG was 2, and the sensitivity, specificity, positive predictive value, and negative predictive value were 81.5%, 72.3%, 43.2%, and 93.8%, respectively. For predicting high-risk stratification and reperfusion therapy, the qSOFA-ECG is superior to PE Severity Index （PESI） and simplified PESI. Conclusions： The qSOFA score contributes to identify acute PE patients with potentially hemodynamic decompensation that need monitoring and possible reperfusion therapy at the emergency department arrival when used in combination with ECG score.

关键词： Electrocardiography Emergency Pulmonary Embolism quick sequential organ failure assessment

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