qSOFA 评分、血乳酸及红细胞分布宽度与急性上消化道出血病情 严重程度的关系及其预测患者预后的效能分析.

Objective: To investigate the relationship between the quick Sequential Organ Failure Assessment (qSOFA) score, blood lactate (Lac) and red blood cell distribution width (RDW) and the severity of illness of acute upper gastrointestinal bleeding (AUGIB) and their efficacy in predicting patient prognosis. Methods: 230 patients with AUGIB who were admitted to our hospital from June 2017 to June 2022 were selected as the research objects. They were divided into low risk group with 44 cases, medium risk group with 140 cases, high risk group with 36 cases, and extremely high risk group with 10 cases according to the severity of the disease. They were also divided into death group (n=31) and survival group (n=199) according to their survival within 28 days after admission. The clinical data of patients with AUGIB were collected, the blood Lac and RDW levels were detected, and the qSOFA score was calculated. Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis of patients with AUGIB, and the predictive value of qSOFA score and blood Lac, RDW on poor prognosis of patients with AUGIB was analyzed by receiver operating characteristic (ROC) curve. Resultds: The qSOFA score, blood Lac and RDW levels in the low risk group, medium risk group, high risk group and extremely high risk group increased in turn (P<0.05). The mortality of 230 patients with AUGIB within 28 days after admission was 13.48%(31/230). Multivariate Logistic regression analysis showed that increased of age, GBS score greater than or equal to 6 scores, shock index, qSOFA score, blood urea nitrogen, blood Lac and RDW levels were independent risk factors for poor prognosis of patients with AUGIB (P<0.05). ROC curve analysis showed that the area under curve of qSOFA score, blood Lac and RDW combined to predict poor prognosis of patients with AUGIB was larger than that of qSOFA score, blood Lac and RDW alone. The increased of qSOFA score, blood Lac and RDW levels in patients with AUGIB is closely related to the aggravation of the disease and poor prognosis. Conclusion: The combination of qSOFA score, blood Lac and RDW has a higher efficacy in predicting the poor prognosis of patients with AUGIB. [ABSTRACT FROM AUTHOR]