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Cited 2 time in webofscience Cited 3 time in scopus
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Prognostic performance of disease severity scores in patients with septic shock presenting to the emergency department

Authors
Choi, AromPark, Yoo SeokShin, Tae GunHan, Kap SuKim, Won YoungKang, Gu HyunKim, KyuseokChoi, Sung-HyukLim, Tae HoSuh, Gil Joon
Issue Date
Jun-2019
Publisher
W B SAUNDERS CO-ELSEVIER INC
Keywords
Sepsis; Shock; Mortality; Prognosis
Citation
AMERICAN JOURNAL OF EMERGENCY MEDICINE, v.37, no.6, pp.1054 - 1059
Indexed
SCIE
SCOPUS
Journal Title
AMERICAN JOURNAL OF EMERGENCY MEDICINE
Volume
37
Number
6
Start Page
1054
End Page
1059
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1965
DOI
10.1016/j.ajem.2018.08.046
ISSN
0735-6757
Abstract
Background: An accurate disease severity score that can quickly predict the prognosis of patients with sepsis in the emergency department (ED) can aid clinicians in distributing resources appropriately or making decisions for active resuscitation measures. This study aimed to compare the prognostic performance of quick sequential organ failure assessment (qSOFA) with that of other disease severity scores in patients with septic shock presenting to an ED. Methods: We performed a prospective, observational, registry-based study.The discriminative ability of each disease severity score to predict 28-day mortality was evaluated in the overall cohort (which included patients who fulfilled previously defined criteria for septic shock), the newly defined sepsis subgroup, and the newly defined septic shock subgroup. Results: A total of 991 patients were included. All disease severity scores had poor discriminative ability for 28-day mortality. The sequential organ failure assessment and acute physiology and chronic health evaluation II scores had the highest area under the receiver-operating characteristic curve (AUC) values, which were significantly higher than the AUC values of other disease severity scores in the overall cohort and the sepsis and septic shock subgroups. The discriminative ability of each disease severity score decreased as the mortality rate of each subgroup increased. Conclusions: All disease severity scores, including qSOFA, did not display good discrimination for 28-day mortality in patients with serious infection and refractory hypotension or hypoperfusion; additionally, none of the included scoring tools in this study could consistently predict 28-day mortality in the newly defined sepsis and septic shock subgroups. (C) 2018 Elsevier Inc. All rights reserved.
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Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
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