アブストラクト
| Title | 第1回 SIRSとqSOFAの意義 |
|---|---|
| Subtitle | 連載 Sepsis-3を検証する |
| Authors | 丸藤哲 |
| Authors (kana) | |
| Organization | 札幌東徳洲会病院 救急集中センター |
| Journal | Thrombosis Medicine |
| Volume | 11 |
| Number | 1 |
| Page | 71-76 |
| Year/Month | 2021 / 3 |
| Article | 報告 |
| Publisher | 先端医学社 |
| Abstract | 「Points」[1]敗血症(sepsis)の診断基準は, Sepsis-1, Sepsis-2, Sepsis-3と変遷してきたが, 2016年に公表されたSepsis-3の妥当性に関して多くの論文が公表されている. [2]Sepsis-1/Sepsis-2のsepsis診断指標であるsystemic inflammatory response syndrome(SIRS)とSepsis-3で提唱された予後予測指標であるquick sequential organ failure assessment(qSOFA)が争点となっている. [3]感染症疑い患者の病院死亡を含む予後をSIRSは高感度/低特異度で, qSOFAは低感度/中等度〜高特異度で予測可能である. [4]SIRS/qSOFAの診断・予後予測指標としての意義と相違を理解し, 両者の診断特性を知悉した臨床応用が必要である. 「はじめに」1992年に敗血症(sepsis)の定義および診断基準を統一し, 共通の病態・背景因子を持つ患者を拾い上げて敗血症研究および治療の標準化を目指すことを目的に新たな敗血症の定義が公表された. |
| Practice | 臨床医学：内科系 |
| Keywords | sepsis, SIRS, qSOFA, SOFA |
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参考文献
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- 4) 丸藤哲:Sepsisの定義および診断基準の歴史的変遷. Thromb Med 8:57-62, 2018
- 5) Seymour CW et al: Assessment of clinical criteria for sepsis: for the Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3). JAMA 315:762-774, 2016
残りの12件を表示する
- 6) Jiang J et al: Head-to-head comparison of qSOFA and SIRS criteria in predicting the mortality of infected patients in the emergency department: a meta-analysis. Scand J Trauma Resusci and Emerg Med 26:56, 2018
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- 8) Song JU et al: Performance of the quick sequential (sepsis-related) organ failure assessment score as a prognostic too in infected patients outside the intensive care unit: a systematic review and meta-analysis. Crit Care 22:28, 2018
- 9) Maitra S et al: Accuracy of quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for predicting mortality in hospitalized patients with suspected infection: a meta-analysis of observational studies. Clin Microb Infect 24:1123-1129, 2018
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- 14) Lo RSL et al: qSOFA is a poor predictor of short-term mortality in all patients: a systematic review of 410.000 patients. J Clin Med 8:61, 2019
- 15) Gando S et al: The SIRS criteria have better performance for predicting infection than qSOFA scores in the emergency department. Sci Rep 10:8095, 2020
- 16) Seymour CW et al: Assessment of clinical criteria for sepsis for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315:762-774, 2016
- 17) Waligora G et al: AAEM Position Paper. Rapid systematic review: the appropriate use of quick sequential organ failure assessment (qSOFA) in the emergency department. J Emerg Med 59:977-983, 2020
