Outcome prediction using the Mortality in Emergency Department Sepsis score combined with procalcitonin for influenza patients
| Autor: | Wen-Xin Liu, Fei Teng, Ji-Fei Cai, Shu-Bin Guo, Tian-Tian Wan, Xuan Qi, Xin Liu |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Logistic regression Procalcitonin Sepsis 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Influenza Human medicine Humans 030212 general & internal medicine Aged Retrospective Studies Receiver operating characteristic business.industry General Medicine Emergency department Odds ratio Middle Aged Prognosis medicine.disease Female SOFA score Observational study Emergency Service Hospital business Biomarkers |
| Zdroj: | Medicina Clínica (English Edition). 153:411-417 |
| ISSN: | 2387-0206 |
| DOI: | 10.1016/j.medcle.2019.03.022 |
| Popis: | Background Severe influenza is often associated with bacterial coinfection and can trigger sepsis, which increases the severity, complexity and mortality of the disease. To determine an effective method for predicting 28-day mortality of emergency department (ED) patients with influenza, we investigated the Mortality in Emergency Department Sepsis (MEDS) score, procalcitonin (PCT) and other relevant biomarkers. Methods We conducted a retrospective, observational, monocentric study, and the endpoint was 28-day mortality. Independent predictors were identified and a new combination predictive model was created both by logistic regression, and the model was evaluated by a receiver operating characteristic (ROC) curve. Results A total of 364 consecutive ED admitted patients with influenza were enrolled and 45 patients died within 28 days. For predicting 28-day mortality, the MEDS score and PCT were independent predictors with adjusted odds ratio of 1.318 (95% CI 1.206–1.439) and 1.038 (95% CI 1.010–1.065), and with AUCs of 0.817 (95% CI 0.756–0.878) and 0.793 (95% CI 0.725–0.861), respectively. The new combination of the MEDS score with PCT significantly improved the efficacy for predicting 28-day mortality with an AUC of 0.857 (95% CI 0.809–0.905), and was superior to the SOFA score with an AUC of 0.837 (95% CI 0.779–0.894). Conclusion The MEDS score and PCT, especially when combined, perform well for predicting mortality of ED admitted patients with influenza. |
| Databáze: | OpenAIRE |
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