Comparison of the Relationship Between SI and RASI Scores With the Outcome of Sepsis Patients

Frontiers in Medicine

article

Amir Masoud Hashemian¹  Zahra Baghshani²  Roohie Farzaneh¹  Hamid Zamani Moghadam¹  Fatemeh Maleki³  Farhad Bagherian⁴  Somayyeh Ahmadnezhad⁵  Mahdi Foroughian¹ 

[1] Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences;Department of Emergency Medicine, Mashhad University of Medical Sciences;Department of Emergency Medicine, Faculty of Medicine, Birjand University of Medical Sciences;Department of Emergency Medicine, Faculty of Medicine, Babol University of Medical Sciences;Department of Emergency Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences

关键词: SI;    RASI;    sepsis;    emergency;    infection;   

DOI  :  10.3389/fmed.2022.872725

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The aim of this study was to compare the relationship between shock index (SI) and respiratory adjusted shock index (RASI) scores with the final outcome of sepsis patients referred to the emergency department. This was prospective research that examined individuals who had been diagnosed with sepsis, determined by the presence of at least two of the three quick sepsis-related organ failure assessment (qSOFA) criteria and the presence of an infectious disease based on a diagnosis made by a hospital physician of Imam Reza and Ghaemshahr of Mashhad in 2019. Demographic information of patients, SI score, RASI score, and information related to the patient's clinical symptoms were recorded in the checklist. The final outcome of this study was considered mortality. Data analysis was performed using descriptive and inferential tests. In the present study, a total of 178 patients, 46 patients (25.8%) were transferred to the intensive care unit, and 98 patients (55.1%) were admitted to the normal wards. Eighty-five patients (47.75%) died and the mean length of hospital stay of all patients was 11.07 ± 9.23 days. Forty-four patients (24.7%) had referred with a decreased level of consciousness and 44 patients (24.7%) presented with confusion. The rest of the patients reported normal levels of consciousness. Kaplan Mir analysis with log-rank was performed to determine the difference in survival distribution in different SI groups: Survival distribution was not statistically different for the four defined groups (based on statistical quartiles ( P = 0.320). Receiver operator curves were considered as the date of death in the case of the deceased and the date of discharge from the hospital in the case of the living as censored. The AUC of the RASI scoring system for predicting mortality was 0.614 ( P = 0.009) while this value was not significant for SI ( P = 0.152). In logistic regression analysis, it was found that by adjusting for the variables of age, sex, sepsis etiology, blood pressure and heart rate, level of consciousness, and gender, patients with the lower respiratory rate (OR 1.6, z = −0.159 p = 0.007), younger age (OR 1.6, z = −0.029 p = 0.006) and higher RASI score are more in risk of mortality (OR 1.29, z = 1.209, p = 0.031). The results of our study showed that RASI scoring can be a good criterion for predicting the chance of mortality in patients with sepsis and could be used complementary to previous criteria such as SI. Patients with high RASI scores should be given more attention to reducing the chance of death.

【 授权许可】

CC BY