A study on multi-organ dysfunction syndrome in malaria using sequential organ failure assessment score.
A study on multi-organ dysfunction syndrome in malaria using sequential organ failure assessment score.
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DOI：
10.4103/tp.tp_12_19
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发表时间：
2020-07
影响因子：
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通讯作者：
Kaushik R
中科院分区：
文献类型：
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作者：
Bhutani A;Kaushik RM;Kaushik R
本研究的目的是探讨疟疾患者多器官功能障碍综合征（MODS）的患病率、临床谱、预后因素和转归。采用序贯器官衰竭评估（SOFA）评分法对124例经外周血涂片和快速疟疾试验阳性诊断的疟疾患者进行MODS研究。疟疾的严重程度按照世界卫生组织的标准进行评估。重症疟疾54例（43.54%）。108例（87.09%）疟疾患者检出MODS，其中恶性疟原虫57例（85.07%），间日疟原虫46例（88.46%），恶性疟原虫和间日疟原虫混合型5例（100%）。MODS组与非MODS组SOFA评分差异有显著性意义（P < 0.001）。MODS与疟疾类型无显著相关性（P = 0.894）。合并MODS的疟疾患者死亡率为5.55%（6/108），其中恶性疟原虫死亡率为8.77%（5/57），间日疟原虫死亡率为2.17%（1/46）。MODS的预后与入院时SOFA评分的严重程度显著相关（P = 0.011），但与疟疾类型、疟原虫指数和受累器官数量无关（均P > 0.05）。入院时SOFA评分与住院时间显著相关（P < 0.0001）。MODS在疟疾中发生率很高，并且不依赖于疟疾的类型。MODS的转归和恢复时间取决于MODS的严重程度。SOFA评分对疟疾患者MODS的诊断、病情严重程度及预后判断有重要意义。
The purpose of this study is to examine the prevalence, clinical spectrum, prognostic factors, and outcome of multi-organ dysfunction syndrome (MODS) in patients with malaria. One hundred and twenty-four patients with malaria, diagnosed by a positive peripheral blood film and rapid malaria test, were studied for MODS using the sequential organ failure assessment (SOFA) score. The severity of malaria was assessed by the WHO criteria. Severe malaria was present in 54 (43.54%) patients. MODS was detected in 108 (87.09%) patients with malaria (Plasmodium falciparum - 57 [85.07%], Plasmodium vivax - 46 [88.46%] and mixed P. falciparum and P. vivax malaria - 5 [100%] cases). SOFA scores of MODS-and non-MODS-patients differed significantly (P < 0.001). No significant association was seen between MODS and type of malaria (P = 0.894). Mortality among malaria patients with MODS was 5.55% (6/108) (P. falciparum 8.77% [5/57] and P. vivax 2.17% [1/46]). The outcome of MODS was associated significantly with the severity of the SOFA score at admission (P = 0.011) but not with the type of malaria, malaria parasite index, and the number of organs involved (P > 0.05 each). The SOFA score at admission correlated significantly with the duration of hospitalization (P < 0.0001). MODS occurs with high frequency in malaria and is not dependent on the type of malaria. The outcome of MODS and recovery time depends on the severity of MODS. The SOFA score is useful in detecting MODS and ascertaining its severity and prognosis in malaria.