Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy: A Multicenter Study
Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy: A Multicenter Study
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DOI：
10.1097/ju.0000000000000195
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发表时间：
2019-08-01
影响因子：
6.6
通讯作者：
Eisnerk, Brian H.
中科院分区：
文献类型：
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作者：
Yaghoubian, Alan;Batter, Timothy;Eisnerk, Brian H.
目的：最近的研究表明，快速序贯器官衰竭评估标准可能比全身炎症反应综合征标准更准确地预测术后脓毒症。在本研究中，我们评估了这 2 个标准预测经皮肾镜取石术后感染性休克的能力。材料和方法：我们对 8 个机构接受经皮肾镜取石术的 320 名患者进行了一项回顾性多中心研究。术后24小时收集快速序贯器官衰竭评估和全身炎症反应综合征的标准。该研究的主要结局是术后感染性休克。次要结局包括 30 天和 90 天的急诊就诊次数以及再入院率。 结果：320 名患者中的 3 名 (0.9%) 符合术后感染性休克的标准。这 3 名患者具有快速序贯器官衰竭评估和全身炎症反应综合征的阳性标准。在整个队列中，23 名患者 (7%) 符合快速序贯器官衰竭评估标准，103 名患者 (32%) 符合全身炎症反应综合征标准。快速序贯器官衰竭评估对术后脓毒症的特异性显着高于全身炎症反应综合征（93.3% vs 68.4%，McNemar 检验 p
Purpose: Recent studies have demonstrated that quick sequential organ failure assessment criteria may be more accurate than systemic inflammatory response syndrome criteria to predict postoperative sepsis. In this study we evaluated the ability of these 2 criteria to predict septic shock after percutaneous nephrolithotomy.Materials and Methods: We performed a retrospective multicenter study in 320 patients who underwent percutaneous nephrolithotomy at a total of 8 institutions. The criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome were collected 24 hours postoperatively. The study primary outcome was postoperative septic shock. Secondary outcomes included 30 and 90-day emergency department visits, and the hospital readmission rate.Results: Three of the 320 patients (0.9%) met the criteria for postoperative septic shock. These 3 patients had positive criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome. Of the entire cohort 23 patients (7%) met quick sequential organ failure assessment criteria and 103 (32%) met systemic inflammatory response syndrome criteria. Specificity for postoperative sepsis was significantly higher for quick sequential organ failure assessment than for systemic inflammatory response syndrome (93.3% vs 68.4%, McNemar test p