1.Predictive value of emergency suspected sepsis risk stratification score for prognosis of patients with sepsis
Clinical Medicine of China 2021;37(3):264-269
Objective:To explore the value of using risk-stratifcation of mergency department suspected sepsis score(REDS) score in the prognosis of patients with sepsis.Methods:The clinical data of sepsis patients hospitalized in Huangshan Shoukang hospital from January 2018 to February 2020 were collected for retrospective case-control study.The REDS, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and mortality in emergency department(MEDS) of all cases were calculated.To evaluate the value of REDS in prognosis of patients with sepsis by comparing REDS with APACHEⅡ and MEDS.Results:Finally 103 patients were enrolled in the study, including 65 males (63.11%) and 38 females (36.89%); the age ranged from 42 to 93 years old, the median (quartile) was 74 (65, 82) years old; 72 patients (69.91%) survived (survival group), 31 patients (30.09%) died (death group). There were significant differences between survival group and death group in REDS((5.28±2.10) score vs.(7.87±2.53) score), MEDS score ((6.64±3.32) score vs.(9.06±3.3) score), APACHE Ⅱ score ((18.96±6.72) score vs.(21.87±6.15) score) (t value were5.404, 3.381 and 2.067, respectively; P value were<0.001, 0.001 and 0.041, respectively). Youden index was biggest(0.381), when REDS was 7.5.The area under the receiver operating characteristic curve was 0.777 (95% CI: 0.678-0.876, P<0.001). When APACHE Ⅱ score was 19.5, Youden index was the largest (0.177), and the area under the ROC of APACHEⅡwas 0.614(95% CI: 0.499-0.729, P=0.068). When the MEDS score was 10.5, Youden index was the largest (0.341), and the area under the receiver operating characteristic curve was 0.696 (95% CI: 0.590-0.802, P=0.002). The area under the curve of working characteristics of the subjects with red score was larger than that of APACHE Ⅱ score ( Z=1.987, P=0.046). Conclusion:REDS has a good effect in judging the condition and prognosis of patients with sepsis, which is equivalent to MEDS score, but better than APACHEⅡ.