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

Yıl 2019, , 10 - 13, 15.03.2019

Mustafa Korkut , Cihan Bedel

https://doi.org/10.25000/acem.468057

Cited By: 1

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?

Öz

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.

Anahtar Kelimeler

qSOFA, lactate, mortality

Kaynakça

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