원저 : 응급실을 통해 패혈증으로 입원한 노인 환자에서 Mortality in Emergency Department Sepsis 점수체계의 타당도 평가
분야
의약학 > 일반외과학
저자
김창환 ( Chang Hwan Kim ) , 이종석 ( Jong Seok Lee ) , 권민성 ( Min Xion Kwon ) , 이창민 ( Chang Min Lee ) , 권오영 ( Oh Young Kwon ) , 최한성 ( Han Sung Choi ) , 홍훈표 ( Hoon Pyo Hong ) , 고영관 ( Young Gwan Ko )
발행기관
대한응급의학회
간행물정보
대한응급의학회지 2012년, 제23권 제4호, 500~509쪽(총10쪽)
파일형식
18402485.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Purpose: The purpose of this study is to validate the Mortality in Emergency Department Sepsis (MEDS) score in older patients with sepsis who visited the emergency department (ED). Methods: This was an observational study. Patients 65 years of age or older with sepsis who were admitted from January, 2010, to May, 2011, in an urban ED with approximately 30,000 annual visits were eligible. Demographic, anthropometric, hemodynamic, and laboratory data were collected. MEDS and Geriatric Nutritional Risk Index (GNRI) scores were calculated as originally described. The area under the receiver operating characteristics curve (AUC) was used for discrimination of each score. Univariate and multivariate analyses were performed. The primary end-point was 28-day in-hospital mortality. Results: Of 397 patients, 11.8%(95% confidence interval, 8.7%~15.0%) died. Mortality stratified according to MEDS was as follows: 0 to 4 points, 0.0%; 5 to 7 points, 4.8%; 8 to 12 points, 11.4%; 13 to 15 points, 22.2%; and ≥ 16 points, 35.7%. Mortality stratified according to GNRI was as follows: > 98 points, 3.9%; 92 to 98 points, 9.8%; 87 to < 92 points, 6.9%; 82 to < 87 points, 20.0%; and < 82 points, 34.6%. AUCs were 0.707 and 0.734 for MEDS and GNRI, respectively. In multiple logistic regression analysis, GNRI was found to be an independent predictor of 28-day in-hospital mortality, however, MEDS was not. Conclusion: The MEDS score performed with moderate accuracy for prediction of 28-day in-hospital mortality in older ED patients with sepsis. These results suggest the need of geriatric-specific risk assessment tools in the ED.
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