Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection

Purpose: Sepsis-3 is a life-threatening organ dysfunction caused by dysregulated host responses to infection; and defined using the Sepsis-3 criteria, introduced in 2016, however, the criteria need to be validated in specific clinical fields. We investigated mortality prediction and compared the diagnostic performance of quick Sequential Organ Failure Assessment (qSOFA), systemic inflammatory response syndrome (SIRS), and burn-specific SIRS (bSIRS) in burn patients.
Methods: This single-center retrospective cohort study examined burn patients in Seoul, Korea during January 2010–December 2020. Overall, 1,391 patients with suspected infection were divided into four sepsis groups using SOFA, qSOFA, SIRS, and burn-specific SIRS.
Results: Hazard ratios (HRs) of all unadjusted models were statistically significant; however, the HR (0.726, p = 0.0080.001) in the SIRS ≥2 group is below 1. In the adjusted model, HRs of the SOFA ≥2 (2.426, p < 0.001), qSOFA ≥2 (7.198, p < 0.001), and SIRS ...

研究目的：脓毒症-3（Sepsis-3）是宿主对感染产生失调反应后引发的危及生命的器官功能障碍，其定义基于2016年推出的Sepsis-3标准，但该标准仍需在特定临床领域中完成验证。本研究旨在开展死亡率预测相关研究，并对比快速序贯器官功能衰竭评分（quick Sequential Organ Failure Assessment, qSOFA）、全身炎症反应综合征（systemic inflammatory response syndrome, SIRS）以及烧伤特异性SIRS（burn-specific SIRS, bSIRS）在烧伤患者中的诊断效能。
研究方法：本研究为单中心回顾性队列研究，纳入2010年1月至2020年12月韩国首尔的烧伤患者。最终共纳入1391例疑似感染患者，依据序贯器官功能衰竭评分（Sequential Organ Failure Assessment, SOFA）、qSOFA、SIRS及烧伤特异性SIRS将其分为4个脓毒症组别。
研究结果：所有未校正模型的风险比（Hazard Ratio, HR）均具有统计学显著性；但SIRS≥2分组的HR为0.726（p = 0.0080.001），数值小于1。在校正模型中，SOFA≥2分组的HR为2.426（p < 0.001）、qSOFA≥2分组的HR为7.198（p < 0.001），以及SIRS……