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조기목적지향치료(Early Goal Directed Therapy, EGDT) 적용 환자의 예후 예측 도구로서 중증도 점수체계의 효율 평가

Other Titles
 Assessment of Severity Scoring Systems for Predicting the Prognosis of Early Goal Directed Therapy (EGDT) Enrolled Patients 
Authors
 김선욱  ;  박인철  ;  박유석  ;  정태녕  ;  유제성  ;  윤인기 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.21(5) : 622-627, 2010 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2010
Keywords
Treatment Outcome ; Sepsis ; Severity of illness index
Abstract
Purpose: Mortality in emergency department sepsis (MEDS), sepsis-related organ failure assessment (SOFA), multiple organ dysfunction score (MODS), and serum lactate levels have shown their efficacy in the early detection of patients with a bad prognosis. However, those studies did not consider differences in treatment protocols and could not rule out the interference of these differences in treatment modalities. Hence, we aimed to assess the performance of MEDS, MODS, SOFA, and serum lactate levels for predicting a bad prognosis in patients scheduled for identical, standardized treatment protocols, EGDT. Methods: Medical records of patients who visited a tertiary level teaching hospital and were enrolled in an EGDT program between October 2009 and May 2010, were retrospectively reviewed. MEDS, SOFA, and MODS scores were calculated and recorded along with serum lactate levels. Receiver operating characteristics (ROC) curves of those predictors of mortality were plotted, Bivariate correlation analyses with overall lengths of admission and ICU lengths of stay were done for surviving patients. Results: None of the diagnostic methods (serum lactate level, MEDS, SOFA, MODS) showed a significant difference difference on ROC analysis (p=0.819, 0.506, 0.811, 0.873, respectively). Bivariate correlation analyses of MEDS, SOFA, MODS and overall lengths of admission showed significant results (p=0.048, 0.018, and 0.003, respectively. Pearson correlation coefficients were, 0.263, 0.312, and 0.381). Only MEDS showed a significant correlation with intensive care unit (ICU) length of stay (p=0.032, Pearson correlation coefficient = 0.332). Conclusion: Neither MEDS, SOFA, MODS, nor serum lactate level can predict mortality in EGDT-enrolled patients. MEDS may be correlated with ICU length of stay
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sun Wook(김선욱)
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Chung, Tae Nyoung(정태녕)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102557
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