Variation in SOFA (Sequential Organ Failure Assessment) Score Performance in Different Infectious States.
Variation in SOFA (Sequential Organ Failure Assessment) Score Performance in Different Infectious States.
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DOI：
10.1177/0885066620944879
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发表时间：
2021-10
影响因子：
3.1
通讯作者：
Moskowitz A
中科院分区：
文献类型：
--
作者：
Pawar RD;Shih JA;Balaji L;Grossestreuer AV;Patel PV;Hansen CK;Donnino MW;Moskowitz A
在本研究中，我们调查了入住重症监护病房 (ICU) 的感染患者的序贯器官衰竭评估 (SOFA) 评分表现是否因感染类型而异。对 2008 年 1 月至 2018 年 4 月期间在城市三级护理中心收治的成人 ICU 感染患者的单中心回顾性研究。根据国际疾病分类第九版 (ICD-9) 和 ICD-10 代码，将患者独特地分为不同的感染类型。感染类型包括肺炎、脑膜炎、菌血症、蜂窝组织炎、胆管炎/胆囊炎、肠道和腹泻疾病、心内膜炎、尿路感染（UTI）和腹膜炎。比较不同感染类型的 SOFA 评分表现和与 SOFA 评分相关的死亡率。总共纳入了 12 283 名患者。其中，50.6% 为女性，中位年龄为 70 岁（四分位距：57-82）。最常见的感染类型是肺炎（32.2%）和尿路感染（31.0%）。总体而言，1703 名患者（13.9%）在出院前死亡。该队列的中位基线 SOFA 评分（入住 ICU 24 小时内）为 5 (3-8)。腹膜炎患者的中位 SOFA 评分最高，为 7 分 (4-9)，蜂窝织炎和尿路感染患者的中位 SOFA 评分最低，为 4 分 (2-7)。预测死亡率的 SOFA 评分区分度在心内膜炎患者中最高（受试者工作特征下面积 [AUC]：0.79，95% CI：0.69–0.90），在孤立性菌血症患者中最低（AUC：0.59，95% CI：0.49–0.70）。根据 SOFA 评分四分位数观察到的死亡率在不同感染类型之间存在显着差异。解释 SOFA 评分时，感染类型是一个重要的考虑因素。这是相关的，因为 SOFA 成为脓毒症定义和预测的重要工具。
In this study, we investigated whether the Sequential Organ Failure Assessment (SOFA) score performance differs based on the type of infection among patients admitted to the intensive care unit (ICU) with infection. Single-center, retrospective study of adult ICU patients admitted with infection between January 2008 and April 2018 at an urban tertiary care center. Patients were uniquely classified into different infection types based on International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes. Infection types included were pneumonia, meningitis, bacteremia, cellulitis, cholangitis/cholecystitis, intestinal and diarrheal disease, endocarditis, urinary tract infection (UTI), and peritonitis. The SOFA score performance and mortality in relation to SOFA score were compared across infection types. A total of 12 283 patients were included. Of these, 50.6% were female and the median age was 70 years (interquartile range: 57–82). The most common infection types were pneumonia (32.2%) and UTI (31.0%). Overall, 1703 (13.9%) patients died prior to hospital discharge. The median baseline SOFA score (within 24 hours of ICU admission) for the cohort was 5 (3–8). Patients with peritonitis had the highest median SOFA score, 7 (4–9), and patients with cellulitis and UTI had the lowest median SOFA score, 4 (2–7). The SOFA score discrimination to predict mortality was highest among patients with endocarditis (area under the receiver operating characteristic [AUC]: 0.79, 95% CI: 0.69–0.90) and lowest for patients with isolated bacteremia (AUC: 0.59, 95% CI: 0.49–0.70). Observed mortality by quartile of SOFA score differed substantially across infection types. Type of infection is an important consideration when interpreting the SOFA score. This is relevant as SOFA emerges as an important tool in the definition and prognostication of sepsis.
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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：
8.8
作者：
Pandharipande, Pratik P.;Shintani, Ayumi K.;Ely, E. Wesley
通讯作者：
Ely, E. Wesley
影响因子：
4.9
作者：
Hattemer, Angela;Hauser, Alan;El-Solh, Ali A.
通讯作者：
El-Solh, Ali A.
影响因子：
8.8
作者：
Levy, MM;Fink, MP;Ramsay, G
通讯作者：
Ramsay, G
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN