Hızlı Sofa skorunun plazma laktat konsantrasyonu ile birlikte kullanımı acil serviste enfeksiyon hastalarındaki mortaliteyi öngörebilir mi?

Öz

Amaç: Hızlı SOFA skorunun plazma laktat düzeyi ile birlikte kullanımının hastane içi mortaliteyi öngörmedeki rolü ile ilgili çok az çalışma vardır. Bu çalışmamızın amacı plazma laktat düzeyi ile kombine bir hızlı SOFA skorunun, acil serviste enfeksiyonlu hastalarda hastane içi mortalite için ilişkili olup olmadığını araştırmaktı.

Yöntemler: Mayıs 2017- Mart 2018 tarihleri arasında acil servise başvuran 60 hastanın qSOFA ve plazma laktat ölçümleri prospektif olarak toplandı. Olguların qSOFA skorunun tek başına ve laktat ile birlikte kullanımının mortaliteyi öngörmedeki analizi yapıldı.

Bulgular: On üç hasta (%21,6) hastaneye yatış süresinde öldü. Laktat ölçümü ile kombine edilmiş qSOFA, qSOFA skoru tek başına kullanımına göre daha başarılı bulunmuştur (sırasıyla AUC = 0,798 ve 0,885, sırasıyla p<0,001). qSOFA için tek başına duyarlılık ve özgüllük %92 ve %54 iken, laktat  ile kombine edilmesiyle sırasıyla %100 ve %43 olduğu saptandı (p<0,001).

Sonuç: qSOFA'nın laktat ile kombine edilmesi, qSOFA’nın tek başına kullanılmasına göre mortalite üzerinde daha yüksek hassasiyete sahiptir.

Anahtar Kelimeler

• qSOFA
• laktat
• mortalite

Can the quick Sequential Organ Failure Assessment (qSOFA) score, combined with plasma lactate concentration, predict the mortality for patients with infections in the emergency department?

Abstract

Aim: Few studies have looked at the predictive role of plasma lactate measure combined with the score of quick sequential organ failure assessment (qSOFA) on hospital mortality. The aim of the study was to investigate whether the score of qSOFA combined with plasma lactate is independently associated with in-hospital mortality among patients with infections in the emergency department (ED).

Methods: Scores of qSOFA and plasma lactate measurements of 60 patients in ED were collected prospectively from May 2017 to March 2018. We used the area under receiver operating characteristic curve (AUC) and sensitivity analysis to compare the applicability of qSOFA score alone and qSOFA score combined with lactate level for patient mortality.

Results: Thirteen patients (21.6%) died in the hospitalization period. According to the qSOFA alone, qSOFA score combined with lactate measurement was more successful (AUC = 0.798 vs. 0.885 p<0.001, respectively). When qSOFA was used alone, sensitivity and specificity were 92% and 54%, otherwise those of the combined with lactate measurement were 100% and 43%, respectively (p<0.001).

Conclusion: Combining the qSOFA with lactate has higher sensitivity for patient mortality than that seen with qSOFA alone.

Keywords

• qSOFA
• lactate
• mortality

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