qSOFA和ECOG评分预测术后无感染癌症患者住院死亡率的有效性

International Journal of Chronic Diseases Pub Date : 2019-05-02 eCollection Date: 2019-01-01 DOI:10.1155/2019/9418971
Silvio A Ñamendys-Silva, Emerson Joachin-Sánchez, Aranza Joffre-Torres, Bertha M Córdova-Sánchez, Guadalupe Ferrer-Burgos, Octavio González-Chon, Angel Herrera-Gomez
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引用次数: 2

摘要

背景:快速顺序器官衰竭评估(qSOFA)和东部肿瘤合作组织(ECOG)量表是简单易行的测量参数,因为它们不需要实验室测试。本研究的目的是比较qSOFA和ECOG在预测术后无感染癌症患者住院死亡率方面的区别能力。方法:前瞻性收集2013-2017年期间除住院患者外所有术后入住ICU的无感染患者资料。结果:共纳入315例患者。ICU和医院死亡率分别为6%和9.2%。qSOFA [AUC=0.75 (95%CI = 0.69-0.79)]与ECOG评分[AUC=0.68 (95%CI =0.62-0.73)] (p=0.221)在预测院内死亡率方面无差异。qSOFA大于1预测院内死亡率具有高敏感性(100%)但低特异性(38.8%);阳性预测值为26.3%,阴性预测值为93.1%,特异性为74.4%,敏感性为55.1%;ECOG评分大于1的阳性预测值为18%,阴性预测值为94.2%。多变量Cox回归分析确定了住院死亡率的两个独立预测因素,分别是住院前最后一个月的ECOG评分(HR: 1.46;95% ci: 1.06-2.00);ICU入院后第1小时计算的qSOFA (OR: 3.17;95% ci: 1.79-5.63)。结论:qSOFA与ECOG在预测院内死亡率方面无差异。入住ICU后1小时的qSOFA评分和住院前最后一个月的ECOG评分与术后无感染癌症患者的住院死亡率相关。qSOFA和ECOG评分有可能被纳入无感染的住院术后癌症患者的早期预警工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Usefulness of qSOFA and ECOG Scores for Predicting Hospital Mortality in Postsurgical Cancer Patients without Infection.

Background: The quick sequential organ failure assessment (qSOFA) and the Eastern Cooperative Oncologic Group (ECOG) scale are simple and easy parameters to measure because they do not require laboratory tests. The objective of this study was to compare the discriminatory capacity of the qSOFA and ECOG to predict hospital mortality in postsurgical cancer patients without infection.

Methods: During the period 2013-2017, we prospectively collected data of all patients without infection who were admitted to the ICU during the postoperative period, except those who stayed in the ICU for <24 hours or patients under 18 years. The ECOG score during the last month before hospitalization and the qSOFA performed during the first hour after admission to the intensive care unit (ICU) were collected. The primary outcome for this study was the in-hospital mortality rate.

Results: A total of 315 patients were included. The ICU and hospital mortality rates were 6% and 9.2%, respectively. No difference was observed between the qSOFA [AUC=0.75 (95% CI = 0.69-0.79)] and the ECOG scores [AUC=0.68 (95%CI =0.62-0.73)] (p=0.221) for predicting in-hospital mortality. qSOFA greater than 1 predicted in-hospital mortality with a high sensitivity (100%) but low specificity (38.8%); positive predictive value of 26.3% and negative predictive value of 93.1% compared to 74.4% of specificity, 55.1% of sensitivity%; positive predictive value of 18% and negative predictive value of 94.2% for an ECOG score greater than 1. Multivariable Cox regression analysis identified two independent predicting factors of in-hospital mortality, which included ECOG score during the last month before hospitalization (HR: 1.46; 95 % CI: 1.06-2.00); qSOFA calculated in the first hours after ICU admission (OR: 3.17; 95 % CI: 1.79-5.63).

Conclusion: No difference was observed between the qSOFA and ECOG for predicting in-hospital mortality. The qSOFA score performed during the first hour after admission to the ICU and ECOG scale during the last month before hospitalization were associated with in-hospital mortality in postsurgical cancer patients without infection. The qSOFA and ECOG score have a potential to be included as early warning tools for hospitalized postsurgical cancer patients without infection.

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