tailieunhanh - Báo cáo y học: " Assessment of disease-severity scoring systems for patients with sepsis in general internal medicine departments"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Assessment of disease-severity scoring systems for patients with sepsis in general internal medicine departments. | Ghanem-Zoubi et al. Critical Care 2011 15 R95 http content 15 2 R95 KS CRITICAL CARE RESEARCH Open Access Assessment of disease-severity scoring systems for patients with sepsis in general internal medicine departments Nesrin O Ghanem-Zoubi Moshe Vardi Arie Laor Gabriel Weber and Haim Bitterman Abstract Introduction Due to the increasing burden on hospital systems most elderly patients with non-surgical sepsis are admitted to general internal medicine departments. Disease-severity scoring systems are used for stratification of patients for utilization management performance assessment and clinical research. Some widely used scoring systems for septic patients are inappropriate when rating non-surgical patients in a non-intensive care unit ICU environment mainly because their calculations require types of data that are frequently unavailable. This study aimed to assess the fitness of four scoring systems for septic patients hospitalized in general internal medicine departments modified early warning score MEWS simple clinical score SCS mortality in emergency department sepsis MEDS score and rapid emergency medicine score REMS . Methods We prospectively collected computerized data of septic patients admitted to general internal medicine departments in our community-based university hospital. We followed 28-day in-hospital mortality overall inhospital mortality and 30- and 60-day mortality. Using a logistic regression procedure we calculated the area under ROC curve AUC for every scoring system. Results Between February 1st 2008 and April 30th 2009 we gathered data of 1 072 patients meeting sepsis criteria on admission to general internal medicine departments. The 28-day mortality was . The AUC for the MEWS was for the SCS for the MEDS and for the REMS . Using Hosmer-Lemeshow statistics a lack of fit was found for the MEDS model. All scoring systems performed better than calculations based on sepsis severity. .