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| Performance of new or old sepsis diagnostic criteria in the prognosis of patients with acute infection in Emergency Department |
| Wang Jun-yu, Wang Hong-wei, Liu Wen-xin, Guo Shu-bin |
| Department of Emergency, Beijing Chaoyang Hospital of the Capital Medical University, Beijing 100020, China |
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Abstract Objective To investigate the performance of new sepsis diagnostic criteria and old sepsis diagnostic criteria in the prognosis of patients with acute infection in Emergence Department (ED). Methods From August 2017 to August 2018, 192 patients with acute infection were admitted to the Emergency Department of Beijing Chaoyang Hospital. The clinical characteristics, lactic acid (Lac) and APACHEⅡscore were examined for each patient. Those patients were divided into new sepsis group (NS group) and new infection group (NI group) by new sepsis diagnosis criteria. Then those patients were divided into old sepsis group (OS group) and old infection group (OI group) by old sepsis diagnosis criteria again. Lac and APACHEⅡscore were compared between NS group and NI group, OS group and OI group. The positive detection rate of Lac and 28-day mortality were calculated in NS group and OS group. The prediction accuracy of APACHEⅡscore and Lac in 28-day mortality was analyzed by ROC curve in NI group, NS group, OS group and OI group. Results APACHEⅡscore and Lac were significantly higher in NS group than those in NI group (scores:11.63±4.5 vs. 7.1±3.6, P＜0.01; mmol/L:3.3±2.6vs. 1.5±0.8, P＜0.01). APACHEⅡscore and Lac were significantly higher in OS group than in OI group (scores:9.6±4.6 vs. 5.6±2.9, P＜0.01; mmol/L:2.4±2.2 vs. 1.5±1.3, P＜0.05).The positive detection rate of Lac had significant difference between NS group and OS group (59.5% vs.38.7%, P＜0.01). Compared with OS group, significant difference was found in the 28-day mortality of the patients in NS group(46.9% vs. 25.8%, P＜0.01). The area under the ROC curve of Lac,APACHEⅡ score was 0.809,0.874 in NS group. The area under the ROC curve of Lac,APACHEⅡ score was 0.827,0.875 in OS group. Conclusion Compared with old sepsis diagnosis criteria,patients with critical acute infection are easy to be identified by new sepsis diagnosis criteria.
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Corresponding Authors:
Guo Shu-bin, E-mail:shubinguo@126.com
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