Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease
Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease
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DOI：
10.1016/j.ajem.2020.07.019
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发表时间：
2020-10-01
影响因子：
3.6
通讯作者：
He, Chengqi
中科院分区：
文献类型：
--
作者：
Liu, Sijia;Yao, Ni;He, Chengqi
目的：入院时评估疾病严重程度有助于降低冠状病毒病（COVID-19）患者的死亡率。本研究旨在评估入院时序贯器官衰竭评估（SOFA）和快速序贯器官衰竭评估（qSOFA）评分系统预测COVID-19患者死亡风险的有效性。方法：我们纳入了140例重症COVID-19患者。使用入院时的人口统计学、临床特征和实验室检查结果数据计算SOFA和qSOFA，以根据病历确定的住院结局（生存或死亡）。结果：SOFA预测死亡率的ROC曲线下面积为0.890（95%CI：0.826-0.955），高于qSOFA（0.742，95%CI 0.657-0.816）。SOFA>= 3的最佳截止值的敏感性、特异性、阳性预测值和阴性预测值分别为90.00%、83.18%、50.00%和97.80%.Conclusions：这份新报告表明，SOFA可以作为危重COVID-19患者入院时有效的连续风险分层工具。qSOFA的性能是可以接受的，但不如SOFA。(C)2020爱思唯尔公司All rights reserved.
Objectives: The assessment of illness severity at admission can contribute to decreased mortality in patients with the coronavirus disease (COVID-19). This study was conducted to evaluate the effectiveness of the Sequential Organ Failure Assessment (SOFA) and Quick Sequential Organ Failure Assessment (qSOFA) scoring systems at admission for the prediction of mortality risk in COVID-19 patients.Methods: We included 140 critically ill COVID-19 patients. Data on demographics, clinical characteristics, and laboratory findings at admission were used to calculate SOFA and qSOFA against the in-hospital outcomes (survival or death) that were ascertained from the medical records. The predictive accuracy of both scoring systems was evaluated by the receiver operating characteristic (ROC) curve analysis.Results: The area under the ROC curve for SOFA in predicting mortality was 0.890 (95% CI: 0.826-0.955), which was higher than that of qSOFA (0.742, 95% CI 0.657-0.816). An optimal cutoff of >= 3 for SOFA had sensitivity, specificity, positive predictive value, and negative predictive value of 90.00%, 83.18%, 50.00%, and 97.80%, respectively.Conclusions: This novel report indicates that SOFA could function as an effective adjunctive risk-stratification tool at admission for critical COVID-19 patients. The performance of qSOFA is accepted but inferior to that of SOFA. (C) 2020 Elsevier Inc. All rights reserved.