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著者: Yudai Ishikawa, Hiroshi Fukushima, Hajime Tanaka, Soichiro Yoshida, Minato Yokoyama, Yoh Matsuoka, Yasuyuki Sakai, Yukihiro Otsuka, Ryoji Takazawa, Masataka Yano, Tetsuro Tsukamoto, Tetsuo Okuno, Akira Noro, Katsushi Nagahama, Shigeyoshi Kamata, Yasuhisa Fujii
雑誌名: Diagnostics (Basel). 2021 Dec 5;11(12). doi: 10.3390/diagnostics11122277. Epub 2021 Dec 5.
Abstract/Text
Prognostic accuracy of the quick sequential organ failure assessment (qSOFA) score for mortality may be limited in elderly patients. Using our multi-institutional database, we classified obstructive acute pyelonephritis (OAPN) patients into young and elderly groups, and evaluated predictive performance of the qSOFA score for in-hospital mortality. qSOFA score ≥ 2 was an independent predictor for in-hospital mortality, as was higher age, and Charlson comorbidity index (CCI) ≥ 2. In young patients, the area under the curve (AUC) of the qSOFA score for in-hospital mortality was 0.85, whereas it was 0.61 in elderly patients. The sensitivity and specificity of qSOFA score ≥ 2 for in-hospital mortality was 80% and 80% in young patients, and 50% and 68% in elderly patients, respectively. For elderly patients, we developed the CCI-incorporated qSOFA score, which showed higher prognostic accuracy compared with the qSOFA score (AUC, 0.66 vs. 0.61, p < 0.001). Therefore, the prognostic accuracy of the qSOFA score for in-hospital mortality was high in young OAPN patients, but modest in elderly patients. Although it can work as a screening tool to determine therapeutic management in young patients, for elderly patients, the presence of comorbidities should be considered at the initial assessment.
PMID 34943514 Diagnostics (Basel). 2021 Dec 5;11(12). doi: 10.3390/diagnostics11122277. Epub 2021 Dec 5.
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