TY  - JOUR
T1  - 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?
TT  - Hızlı Sofa skorunun plazma laktat konsantrasyonu ile birlikte kullanımı acil serviste enfeksiyon hastalarındaki mortaliteyi öngörebilir mi?
AU  - Korkut, Mustafa
AU  - Bedel, Cihan
PY  - 2019
DA  - March
DO  - 10.25000/acem.468057
JF  - Archives of Clinical and Experimental Medicine
JO  - Arch Clin Exp Med
PB  - Mustafa HASBAHÇECİ
WT  - DergiPark
SN  - 2564-6567
SP  - 10
EP  - 13
VL  - 4
IS  - 1
LA  - en
AB  - Aim: Few studies have looked at the predictive roleofplasma lactate measure combined with the score of quick sequentialorgan failure assessment (qSOFA) on hospital mortality. The aim of the studywas to investigate whetherthe score of qSOFA combined withplasmalactate is independently associated with in-hospital mortalityamong patients with infections in the emergency department (ED).Methods: Scores of qSOFA and plasma lactate measurements of 60patients in ED were collected prospectively from May 2017 to March 2018. Weused the area under receiver operating characteristic curve (AUC) andsensitivity analysis to compare the applicability of qSOFA score alone andqSOFA score combined with lactate level for patient mortality.Results:Thirteen patients (21.6%) died inthe hospitalization period. According to the qSOFA alone, qSOFA score combinedwith 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% and43%, respectively (p<0.001).Conclusion: Combining the qSOFA withlactate has higher sensitivity for patient mortality than that seen with qSOFAalone.
KW  - qSOFA
KW  - lactate
KW  - mortality
N2  - Amaç: Hızlı SOFA skorununplazma laktat düzeyi ilebirlikte kullanımının hastane içi mortaliteyi öngörmedeki rolü ile ilgili çokaz çalışma vardır. Bu çalışmamızın amacı plazma laktat düzeyi ile kombinebirhızlı SOFA skorunun, acil serviste enfeksiyonlu hastalarda hastane içimortalite için ilişkili olup olmadığını araştırmaktı.Yöntemler: Mayıs 2017- Mart 2018 tarihleri arasında acil servisebaşvuran60 hastanın qSOFA ve plazma laktat ölçümleri prospektif olarak toplandı.Olguların qSOFA skorunun tek başına velaktat ile birlikte kullanımınınmortaliteyi öngörmedeki analizi yapıldı.Bulgular: On üç hasta (%21,6) hastaneye yatış süresinde öldü.Laktat ölçümü ile kombine edilmiş qSOFA, qSOFA skoru tek başına kullanımınagöre daha başarılı bulunmuştur (sırasıyla AUC = 0,798 ve 0,885, sırasıylap<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’nıntek başına kullanılmasına göre mortalite üzerinde daha yüksekhassasiyete sahiptir.
CR  - 1.	Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock. JAMA. 2016;315:801-10.
CR  - 2.	Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock. JAMA. 2016;315:762-74.
CR  - 3.	Casserly B, Phillips GS, Schorr C, Dellinger RP, Townsend SR, Osborn TM, et al. Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med. 2015;43:567-73.
CR  - 4.	Mikkelsen ME, Miltiades AN, Gaieski DF, Goyal M, Fuchs BD, Shah CV, et al. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. 2009;37:1670-7.
CR  - 5.	Del Portal DA, Shofer F, Mikkelsen ME, Dorsey Jr PJ, Gaieski DF, Goyal M, et al. Emergency department lactate is associated with mortality in older adults admitted with and without infections. Acad Emerg Med. 2010;17:260-8.
CR  - 6.	Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Crit Care Med. 2007;44:27-72.
CR  - 7.	Sartelli M, Kluger Y, Ansaloni L, Hardcastle TC, Rello J, Watkins RR, et al. Raising concerns about the Sepsis-3 definitions. World J Emerg Surg. 2018;13:6.
CR  - 8.	Williams JM, Greenslade JH, McKenzie JV, Chu K, Brown AF, Lipman J. Systemic inflammatory response syndrome, quick sequential organ function assessment, and organ dysfunction: insights from a prospective database of ED patients with infection. Chest. 2017;151:586-96.
CR  - 9.	Dorsett M, Kroll M, Smith CS, Asaro P, Liang SY, Moy HP. qSOFA has poor sensitivity for prehospital identification of severe sepsis and septic shock. Prehosp Emerg Care. 2017;21:489-97.
CR  - 10.	Shapiro NI, Wolfe RE, Moore RB, Smith E, Burdick E, Bates DW. Mortality in Emergency Department Sepsis (MEDS) score: a prospectively derived and validated clinical prediction rule. Crit Care Med. 2003;31:670-5.
CR  - 11.	Singer AJ, Ng J, Thode Jr HC, Spiegel R, Weingart S. Quick SOFA scores predict mortality in adult emergency department patients with and without suspected infection. Ann Emerg Med. 2017;69:475-9.
CR  - 12.	Chebl RB, El Khuri C, Shami A, Rajha E, Faris N, Bachir R, et al. Serum lactate is an independent predictor of hospital mortality in critically ill patients in the emergency department: a retrospective study. Scand J Trauma Resusc Emerg Med. 2017;25:69.
CR  - 13.	Lokhandwala S, Andersen LW, Nair S, Patel P, Cocchi MN, Donnino MW. Absolute lactate value vs relative reduction as a predictor of mortality in severe sepsis and septic shock. J Crit Care. 2017;37:179-84.
CR  - 14.	Shapiro NI, Fisher C, Donnino M, Cataldo L, Tang A, Trzeciak S, et al. The feasibility and accuracy of point-of-care lactate measurement in emergency department patients with suspected infection. J Emerg Med.  2010;39:89-94.
UR  - https://doi.org/10.25000/acem.468057
L1  - http://dergipark.org.tr/tr/download/article-file/671622
ER  -