응급실 환자 분류소에서 중증 패혈증 및 패혈 쇼크 환자의 조기 발견 및 예후 예측 (Early Detection and Prognosis Prediction of Severe sepsis and Septic shock in Emergency Triage Room)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 19권 / 6호 / 657 ~ 664페이지
· 저자명 : 백성훈, 이경미, 홍대영, 한승백, 김강호, 김준식, 김지윤, 김환철, 김지혜

초록

Purpose: Early goal-directed therapy in severe sepsis and
septic shock improves patient outcomes, and early diagnosis
of sepsis is essential for early therapy. We designed this
study to identified parameters for early sepsis detection and
risk stratification based on initial vital signs.
Methods: We reviewed the medical records of all adult
patients without trauma who visited the emergency department
at Inha University Hospital between January, 2007,
and June, 2007. Patients who met all Systemic
Inflammatory Response Syndrome (SIRS) criteria, except
white blood cell count, were included and divided into sepsis
and non-sepsis groups. All sepsis patients were classified
by severity as uncomplicated sepsis, severe sepsis, or
septic shock. In addition, all sepsis patients were further
classified into two groups by outcome. The parameters
were compared based on initial vital signs for each group,
and cut-off values were obtained.
Results: There were statistically significant differences in
body temperature and shock index (SI) between SIRS nonsepsis
and sepsis patients, as well as significant differences
in systolic blood pressure (SBP), diastolic blood pressure
(DBP), mean arterial pressure (MAP) and SI between
uncomplicated sepsis and complicated sepsis. Differences
in SBP, DBP, MAP, pulse rate, respiratory rate, and SI
between the survival and non-survival groups were statistically
significant.
Conclusion: The results of this study may help emergency
physicians detect severe sepsis, septic shock, and high-risk
sepsis patients in emergency triage.

영어초록

Purpose: Early goal-directed therapy in severe sepsis and
septic shock improves patient outcomes, and early diagnosis
of sepsis is essential for early therapy. We designed this
study to identified parameters for early sepsis detection and
risk stratification based on initial vital signs.
Methods: We reviewed the medical records of all adult
patients without trauma who visited the emergency department
at Inha University Hospital between January, 2007,
and June, 2007. Patients who met all Systemic
Inflammatory Response Syndrome (SIRS) criteria, except
white blood cell count, were included and divided into sepsis
and non-sepsis groups. All sepsis patients were classified
by severity as uncomplicated sepsis, severe sepsis, or
septic shock. In addition, all sepsis patients were further
classified into two groups by outcome. The parameters
were compared based on initial vital signs for each group,
and cut-off values were obtained.
Results: There were statistically significant differences in
body temperature and shock index (SI) between SIRS nonsepsis
and sepsis patients, as well as significant differences
in systolic blood pressure (SBP), diastolic blood pressure
(DBP), mean arterial pressure (MAP) and SI between
uncomplicated sepsis and complicated sepsis. Differences
in SBP, DBP, MAP, pulse rate, respiratory rate, and SI
between the survival and non-survival groups were statistically
significant.
Conclusion: The results of this study may help emergency
physicians detect severe sepsis, septic shock, and high-risk
sepsis patients in emergency triage.

참고자료

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