- 期刊
Prognostic Validation of Pitt Bacteremia Score, Sequential Organ Failure Assessment and Quick Sequential Organ Failure Assessment Scores in Hospitalized Patients with Invasive Candida Infections
以Pitt菌血症得分、連續器官衰竭評估指數及快速連續器官衰竭評估指數評估罹患侵襲性念珠菌感染的住院病患癒後
摘要
Objective: This study determined the prognostic abilities of the Pitt Bacteremia Score (PBS), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA) in hospitalized adults with invasive candidiasis.. Methods: Adults hospitalized between 2013 and 2016 at Tainan Municipal An Nan Hospital whose sterile body site specimens yielded Candida were retrospectively analyzed. Results: Of 951 patients with Candida infections, 58 (aged 66.2 ± 13.2 years) were included. PBS, SOFA, and qSOFA scores averaged 2.12 ± 3.15 (range 0-14), 4.57 ± 4.45 (range 0-16), and 0.69 ± 0.78 (range 0- 3), respectively. The average PBS, SOFA, and qSOFA scores in nonsurvivors versus survivors were 3.78 versus 1.03 (p ＜ 0.003), 7.17 versus 2.86 (p ＜ 0.001), and 1.09 versus 0.43 (p ＜ 0.005), respectively. The areas under the receiver operating characteristic (ROC) curve predicting in-hospital mortality for PBS, SOFA, and qSOFA scores were 0.78 (95% CI 0.66-0.88), 0.75 (95% CI 0.62-0.86), and 0.70 (95% CI 0.56-0.81), respectively. The area differences in ROCs between PBS and SOFA, SOFA and qSOFA, and qSOFA and PBS were 0.03 (95% CI, -0.09-0.15), 0.09 (95% CI, -0.09-0.21), and 0.06 (95% CI, -0.08-0.19), respectively. Conclusion: PBS was the most accurate predictor among these three systems.
並列摘要
目的：以侵襲性念珠菌感染住院病患之Pitt菌血症得分（PBS）、連續器官衰竭評估指數（SOFA）及快速連續器官衰竭評估指數（qSOFA）評估病患癒後並檢驗其效度。方法：2013至2016年回溯性分析南台灣某區域醫院念珠菌資料，無菌部位分離出念珠菌者為侵襲性念珠菌感染，並分析病患資料。結果：研究期間共有951念珠菌感染病人，58位為侵襲性念珠菌感染（年齡66.2±13.2歲）。病人之PBS、SOFA及qSOFA分別為2.12±3.15（範圍0-14）、4.57±4.45（範圍0-16）及0.69±0.78（範圍0-3）。PBS、SOFA及qSOFA平均分數在因侵襲性念珠菌感染死亡及存活者比較分別為3.78比1.03（p＜0.003）、7.17比2.86（p＜0.001）及1.09比0.43（p＜0.005）。以PBS、SOFA及qSOFA預測住院病患死亡率所得之受試者工作特徵曲線（ROC）厎下之面積分別為0.78（95%信賴區間0.66-0.88）、0.75（95%信賴區間0.62-0.86）及0.70（95%信賴區間0.56-0.81）。PBS和SOFA、SOFA和qSOFA及qSOFA和PBS兩兩ROC厎下之面積差分別為0.03（95%信賴區間-0.09-0.15）、0.09（95%信賴區間-0.09-0.21）及0.06（95%信賴區間-0.08-0.19）。結論：三項指標中PBS為最佳預測侵襲性念珠菌感染的住院病患死亡率。