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Efficacy of quick Sequential Organ Failure Assessment with lactate concentration for predicting mortality in patients with community-acquired pneumonia in the emergency department
Clinical and Experimental Emergency Medicine ; (4): 1-8, 2019.
Article in English | WPRIM | ID: wpr-785597
ABSTRACT

OBJECTIVE:

Community-acquired pneumonia (CAP) is a major cause of sepsis, and sepsis-related acute organ dysfunction affects patient mortality. Although the quick Sequential Organ Failure Assessment (qSOFA) is a new screening tool for patients with suspected infection, its predictive value for the mortality of patients with CAP has not been validated. Lactate concentration is a valuable biomarker for critically ill patients. Thus, we investigated the predictive value of qSOFA with lactate concentration for in-hospital mortality in patients with CAP in the emergency department (ED).

METHODS:

From January 2015 to June 2015, 443 patients, who were diagnosed with CAP in the ED, were retrospectively analyzed. We defined high qSOFA or lactate concentrations as a qSOFA score ≥2 or a lactate concentration >2 mmol/L upon admission at the ED. The primary outcome was all-cause in-hospital mortality.

RESULTS:

Among the 443 patients, 44 (9.9%) died. Based on the receiver operating characteristic (ROC) analysis, the areas under the curves for the prediction of mortality were 0.720, 0.652, and 0.686 for qSOFA, CURB-65 (confusion, urea, respiratory rate, blood pressure, and age), and Pneumonia Severity Index, respectively. The area under the ROC curve of qSOFA was lower than that of SOFA (0.720 vs. 0.845, P=0.004). However, the area under the ROC curve of qSOFA with lactate concentration was not significantly different from that of SOFA (0.828 vs. 0.845, P=0.509). The sensitivity and specificity of qSOFA with lactate concentration were 71.4% and 83.2%, respectively.

CONCLUSION:

qSOFA with lactate concentration is a useful and practical tool for the early prediction of in-hospital mortality among patients with CAP in the ED.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pneumonia / Urea / Blood Pressure / Mass Screening / Retrospective Studies / ROC Curve / Mortality / Sensitivity and Specificity / Hospital Mortality / Critical Illness Type of study: Diagnostic study / Observational study / Prognostic study / Screening study Limits: Humans Language: English Journal: Clinical and Experimental Emergency Medicine Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pneumonia / Urea / Blood Pressure / Mass Screening / Retrospective Studies / ROC Curve / Mortality / Sensitivity and Specificity / Hospital Mortality / Critical Illness Type of study: Diagnostic study / Observational study / Prognostic study / Screening study Limits: Humans Language: English Journal: Clinical and Experimental Emergency Medicine Year: 2019 Type: Article