中文版的简化SOFA评分在社区获得性肺炎病情评估中的价值研究

目的探讨中文版的简化SOFA评分(C-sSOFA评分)对社区获得性肺炎(CAP)患者病情评估的价值,并与肺炎严重程度指数(PSI)评分比较。方法回顾性分析2016年1月至2019年6月在我院呼吸内科住院的CAP患者的临床资料,分别计算每一例患者的C-sSOFA评分、PSI评分,然后进行统计学分析。结果 120例患者被纳入研究,男94例(78.33%),女26例(21.67%),年龄最小20岁,最大92岁,四分位数为66 (51,78)]岁。120例中重症CAP组27例(22.50%),非重症CAP组93例(77.50%);治疗后好转95例(79.17%),好转组;转ICU 25例(20.83%),转ICU组。PSI评分最低25分,最高195分,平均86.80±30.04分;C-sSOFA评分最低1分,最高7分,四分位数3(3,4)。转ICU组和好转组住呼吸内科时间与C-sSOFA评分的相关系数分别是r_s=-0.851(P<0.001)、r_s=0.813(P<0.001)。转ICU组和好转组住呼吸内科时间与PSI评分的相关系数分别是r_s=-0.759(P<0.001)、r_s=0.761(P<0.001)。C-sSOFA评分预测转入ICU的ROC曲线下面积0.881(95%可信区间:0.818~0.944,P<0.001),评分3.5时Youden指数最大,为0.526。PSI评分预测转入ICU的ROC曲线下面积0.839(95%可信区间:0.730~0.948,P<0.001),评分87.5时Youden指数最大,为0.551。结论 C-sSOFA评分在CAP患者病情判断中有一定的价值,优于PSI评分。

Study on the value of Chinese-simlpe sequential organ failure assessment to assess the severity of community-acquired pneumonia

Objective To explore the value of Chinese-simlpe sequential organ failure assessment(C-sSOFA) to assess the severity of community-acquired pneumonia while compared with pneumonia severity index(PSI).Methods All adult patients admitted to our Department of Respiratory Medicine from January 2016 to June 2019 were retrospectively analyzed. The severity was evaluated by C-sSOFA and PSI,then statistic analysis was performed.Results There were a total of 120 cases included,including 94 male cases( 78. 33%) and 26 female cases( 21. 67%). The youngest age was 20 years old and the oldest was 92 years and,with a median age of 66( 51,78)years respectively. 27 cases were severe community-acquired pneumonia,and 93 cases were not severe communityacquired pneumonia. After treatment,95 cases were improved and 25 cases turned into ICU. The lowest PSI score was 25 and the highest was 195,with the mean score of( 86. 80 ± 30. 04) respectively. The lowest score of C-sSOFA was 1,and the highest was 7,with a mean score of 3( 3,4) respectively. The related coefficient of residence time in respiratory medicine and C-sSOFA score were-0. 851( P < 0. 001) and 0. 813( P < 0. 001) respectively in the ICU group and the improved group. The related coefficient of residence time in respiratory medicine and PSI score were-0. 759( P < 0. 001) and 0. 761( P < 0. 001) respectively in the two groups. The area under the ROC of CsS OFA score was 0. 881( 95% CI 0. 818 ~ 0. 944),and Youden index was the highest when C-sSOFA score was 3. 5.The area under the ROC of PSI score was 0. 839( 95% CI: 0. 730 ~ 0. 948,P < 0. 001),and Youden index was the highest when PSI score was 87. 5. Conclusion C-sSOFA is useful to evaluate the severity of community-acquired pneumonia and better than PSI,which is easy to perform.