Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: a multinational multicenter prospective observational study.
Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: a multinational multicenter prospective observational study.
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DOI：
10.1186/s40560-018-0279-7
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发表时间：
2018
影响因子：
7.1
通讯作者：
for Southeast Asia Infectious Disease Clinical Research Network
中科院分区：
文献类型：
--
作者：
Lie KC;Lau CY;Van Vinh Chau N;West TE;Limmathurotsakul D;for Southeast Asia Infectious Disease Clinical Research Network
脓毒症是一种全球性威胁，但在东南亚研究不足。目的是评价东南亚社区获得性脓毒症患者的管理、结局、脓毒症捆绑治疗依从性和最大序贯器官衰竭评估（SOFA）评分的死亡率预测。我们前瞻性招募了印度尼西亚（n = 3）、泰国（n = 3）和越南（n = 3）9家公立医院入院24小时内社区获得性感染的住院成人。在器官功能障碍患者（SOFA总评分≥ 2）中，我们分析了脓毒症的管理和结局，并评估了SOFA评分的死亡率预测。器官衰竭定义为单个器官系统的最大SOFA评分≥ 3。从2013年12月至2015年12月，入组了454例因不同病因而出现社区获得性脓毒症的成人患者。入院24 h内脓毒症集束治疗的依从性较低：76%（344/454）的患者使用广谱抗生素，50%的低血压或乳酸≥ 4 mmol/L的患者使用≥ 1500 mL液体（115/231），71%的低血压患者使用肾上腺素能药物（135/191）。355例患者（78%）在ICU外接受治疗。99例患者（22%）死亡。随后死亡的患者入院时的SOFA总评分显著高于存活患者（6.7 vs. 4.6，p < 0.001）。器官衰竭的数量与28天死亡率显著相关，从无任何器官衰竭的患者的7%到至少有四个器官衰竭的患者的47%（p < 0.001）。用于区分死亡率的SOFA总分的受试者工作特征曲线下面积为0.68（95%CI 0.62-0.74）。在东南亚，由于各种病原体引起的社区获得性脓毒症通常在ICU外进行管理，并且对脓毒症治疗的依从性较差。在该人群中，SOFA评分的计算是可行的，SOFA评分与死亡率相关。ClinicalTrials.gov，NCT02157259。2014年6月5日注册，追溯注册。本文的在线版本（10.1186/s40560-018-0279-7）包含补充材料，可供授权用户使用。
Sepsis is a global threat but insufficiently studied in Southeast Asia. The objective was to evaluate management, outcomes, adherence to sepsis bundles, and mortality prediction of maximum Sequential Organ Failure Assessment (SOFA) scores in patients with community-acquired sepsis in Southeast Asia. We prospectively recruited hospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia (n = 3), Thailand (n = 3), and Vietnam (n = 3). In patients with organ dysfunction (total SOFA score ≥ 2), we analyzed sepsis management and outcomes and evaluated mortality prediction of the SOFA scores. Organ failure was defined as the maximum SOFA score ≥ 3 for an individual organ system. From December 2013 to December 2015, 454 adult patients presenting with community-acquired sepsis due to diverse etiologies were enrolled. Compliance with sepsis bundles within 24 h of admission was low: broad-spectrum antibiotics in 76% (344/454), ≥ 1500 mL fluid in 50% of patients with hypotension or lactate ≥ 4 mmol/L (115/231), and adrenergic agents in 71% of patients with hypotension (135/191). Three hundred and fifty-five patients (78%) were managed outside of ICUs. Ninety-nine patients (22%) died. Total SOFA score on admission of those who subsequently died was significantly higher than that of those who survived (6.7 vs. 4.6, p < 0.001). The number of organ failures showed a significant correlation with 28-day mortality, which ranged from 7% in patients without any organ failure to 47% in those with failure of at least four organs (p < 0.001). The area under the receiver operating characteristic curve of the total SOFA score for discrimination of mortality was 0.68 (95% CI 0.62–0.74). Community-acquired sepsis in Southeast Asia due to a variety of pathogens is usually managed outside the ICU and with poor compliance to sepsis bundles. In this population, calculation of SOFA scores is feasible and SOFA scores are associated with mortality. ClinicalTrials.gov, NCT02157259. Registered 5 June 2014, retrospectively registered. The online version of this article (10.1186/s40560-018-0279-7) contains supplementary material, which is available to authorized users.
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影响因子：
5.7
作者：
Semler, Matthew W.;Rice, Todd W.
通讯作者：
Rice, Todd W.
幸存的败血症运动：严重败血症和化粪池冲击管理的国际指南，2012年。
影响因子：
38.9
作者：
Dellinger RP;Levy MM;Rhodes A;Annane D;Gerlach H;Opal SM;Sevransky JE;Sprung CL;Douglas IS;Jaeschke R;Osborn TM;Nunnally ME;Townsend SR;Reinhart K;Kleinpell RM;Angus DC;Deutschman CS;Machado FR;Rubenfeld GD;Webb S;Beale RJ;Vincent JL;Moreno R;Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
通讯作者：
Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
DOI：
10.1001/jama.2016.0288
发表时间：
2016-02-23
期刊：
JAMA
影响因子：
--
作者：
Seymour CW;Liu VX;Iwashyna TJ;Brunkhorst FM;Rea TD;Scherag A;Rubenfeld G;Kahn JM;Shankar-Hari M;Singer M;Deutschman CS;Escobar GJ;Angus DC
通讯作者：
Angus DC
影响因子：
158.5
作者：
Maitland, Kathryn;Kiguli, Sarah;Gibb, Diana M.
通讯作者：
Gibb, Diana M.
影响因子：
3.7
作者：
Papali, Alfred;Verceles, Avelino C.;West, T. Eoin
通讯作者：
West, T. Eoin