The National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (qSOFA), and modified qSOFA (MqSOFA) are scoring systems that rely on vital signs. However, NEWS is time-consuming, qSOFA has low sensitivity, and MqSOFA includes a difficult calculation. To address these issues, we developed the Revised qSOFA score (RqSOFA) that consists of percutaneous oxygen saturation, oxygen usage, Simple Shock Index, and the parameters of qSOFA. The predictability of RqSOFA was examined for in-hospital mortality among patients who were transported by ambulance. This observational cohort study included all patients transported via ambulance to an Emergency Department between 2019 and 2021. Patients who had prehospital cardiopulmonary arrest, were pregnant, were younger than 15 years old, arrived from another hospital, and had missing data were excluded. The Area Under the Receiver Operating Characteristic curve (AUROC) of RqSOFA, as well as its sensitivity and specificity at the optimal cut-off point, were determined and compared to those of qSOFA, NEWS and MqSOFA. Among 1849 included patients, 53 died in the hospital. The AUROC for RqSOFA was 0.867 and the optimal cut-off point was 2. The sensitivity and specificity were 0.849 and 0.802, respectively. The AUROC of RqSOFA was larger than qSOFA but had no significance with NEWS and MqSOFA. RqSOFA exhibited the same sensitivity and better specificity compared to NEWS. There were no differences in sensitivity and specificity between RqSOFA and MqSOFA. In conclusion, RqSOFA exhibited superior predictability for in-hospital mortality to qSOFA and NEWS, while offering similar predictability to MqSOFA despite relying only on simple measurements.
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http://dx.doi.org/10.1007/s11739-024-03833-y | DOI Listing |
Clin Nutr
December 2024
Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address:
Background: Trimethylamine N-oxide (TMAO) is a gut microbial metabolite derived from dietary l-carnitine and choline. High plasma TMAO levels are associated with cardiovascular disease and overall mortality, but little is known about the associations of TMAO and related metabolites with the risk of kidney function decline among patients with chronic kidney disease (CKD).
Methods: We prospectively followed 152 nondialysis patients with CKD stages 3-5 and measured plasma TMAO and related metabolites (trimethylamine [TMA], choline, carnitine, and γ-butyrobetaine) via liquid chromatography‒mass spectrometry.
J Intern Med
December 2024
Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Expert Rev Respir Med
December 2024
Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Introduction: Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the CF transmembrane regulator (CFTR) gene, leading to progressive lung disease and systemic complications. Lung disease remains the primary cause of morbidity and mortality, making early detection of lung function decline crucial. The Lung Clearance Index (LCI), derived from the multiple breath washout (MBW) test, has emerged as a sensitive measure for identifying early airway disease.
View Article and Find Full Text PDFWorld J Surg Oncol
December 2024
Department of Radiation Oncology, Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou, Guangdong, 510095, People's Republic of China.
Background: The combination of immunotherapy and chemotherapy has demonstrated an enhancement in progression-free survival (PFS) for individuals with advanced and metastatic triple-negative breast cancer (TNBC) when compared to the use of chemotherapy alone. Nevertheless, the extent to which different subgroups of metastatic TNBC patients experience this benefit remains uncertain.
Objectives: Our objective was to conduct subgroup analyses to more precisely identify the factors influencing these outcomes.
Crit Care
December 2024
Division of Anesthesia, Critical Care, Pain and Emergency Medicine, UR‑UM103 IMAGINE, University of Montpellier, Nimes University Hospital, Nîmes, France.
Background: In septic shock, the classic fluid resuscitation strategy can lead to a potentially harmful positive fluid balance. This multicenter, randomized, single-blind, parallel, controlled pilot study assessed the effectiveness of a restrictive fluid strategy aiming to limit daily volume.
Methods: Patients 18-85 years' old admitted to the ICU department of three French hospitals were eligible for inclusion if they had septic shock and were in the first 24 h of vasopressor infusion.
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