Extrarenal sequential organ failure assessment score as an outcome predictor of critically ill children on continuous renal replacement therapy
Extrarenal sequential organ failure assessment score as an outcome predictor of critically ill children on continuous renal replacement therapy
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DOI：
10.1007/s00467-013-2741-z
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发表时间：
2014-06-01
影响因子：
3
通讯作者：
Park, Seong Jong
中科院分区：
文献类型：
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作者：
Jhang, Won Kyoung;Kim, Young A.;Park, Seong Jong
序贯器官衰竭评估（SOFA）评分易于计算，并已被很好地验证为危重成人患者的结局预测因子。然而，其在儿童中的使用受到限制，主要是因为血清肌酐基础参考水平的差异，数据包括2005年1月至2011年7月期间需要连续性肾脏替代治疗（CRRT）的87例患者。基于CRRT可能减轻肾脏对结局的影响的假设，我们通过将肾脏成分排除为肾外SOFA评分来修改SOFA评分，并通过与儿科死亡风险（PRISM）III、儿科逻辑器官功能障碍（PELOD）结果显示：83例患者中95.4%（n = 83）发生多器官功能障碍综合征，总死亡率为50.6%。CRRT开始时的肾外SOFA评分和千分之一日元20%液体超负荷与死亡率显著相关。与各种评分系统的预测能力相比，肾外SOFA评分显示了最大的受试者工作特征曲线下面积（肾外SOFA 0.774，SOFA 0.770，PRISM III 0.660和PELOD 0.650）。肾外SOFA评分可能是接受CRRT治疗的危重患儿的有用预后指标。
The sequential organ failure assessment (SOFA) score is easy to calculate and has been well validated as an outcome predictor in critically ill adult patients. However, its use in children has been limited, mainly because of differences in basal reference levels of serum creatinine.Data include 87 patients requiring continuous renal replacement therapy (CRRT) between January 2005 and July 2011. We modified the SOFA score by excluding the renal component to an extrarenal SOFA score, based on the assumption that CRRT may mitigate the renal effect on outcome and investigated the utility in predicting outcome with comparison with pediatric risk of mortality (PRISM) III, pediatric logistic organ dysfunction (PELOD), and SOFA scores.Results showed that 95.4 % (n = 83) had multiple organ dysfunction syndrome with an overall mortality of 50.6 %. The extrarenal SOFA score at CRRT initiation and a parts per thousand yen20 % fluid overload were significantly associated with mortality. In comparison with the predictive power of various scoring systems, the extrarenal SOFA score showed the largest area under the receiver operating characteristic curve (extrarenal SOFA 0.774, SOFA 0.770, PRISM III 0.660, and PELOD 0.650).The extrarenal SOFA score may be a useful prognostic marker in critically ill children treated with CRRT.