RESUMEN
INTRODUCTION: The "quick Sequential Organ Failure Assessment" (qSOFA) score is a bedside risk-stratification tool to predict the likelihood of organ dysfunction. This study evaluated the qSOFA score as a prognostic factor for 30-day mortality in emergency department (ED) patients with sepsis identified by the Systemic Inflammatory Response Syndrome (SIRS) criteria. METHODS: A historical cohort study was conducted reviewing patients admitted to a single-center ED from November 1, 2013, to October 31, 2014. All patients with suspected or proven infections who fulfilled two or more SIRS criteria were included. Data of SIRS, qSOFA and baseline clinical data were obtained from triage forms and patient records. RESULTS: A total of 434 patients with sepsis of any severity were included. A total of 73 (16.8%) had a qSOFA score of ≥2 and were more frequently transferred to the intensive care unit (ICU) (26.0 vs. 6.7%; 95% confidence interval (CI) of the difference 8.9-29.7%) and had increased 30-day mortality (32.9 vs. 9.1%, 95% CI of the difference 12.6-35.0%) compared to patients with a qSOFA score of <2. In an adjusted logistic regression model, a qSOFA score of ≥2 was independently associated with 30-day mortality (odds ratio 4.83; 95% CI 2.11-11.02). CONCLUSION: Almost one third of the patients with a qSOFA score of ≥2 had died within 30â¯days and a qSOFA score of ≥2 was independently associated with mortality. This study indicated that qSOFA score of at least two could provide useful prognostic information for septic patients defined by the SIRS criteria.
Asunto(s)
Puntuaciones en la Disfunción de Órganos , Sepsis/mortalidad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Servicio de Urgencia en Hospital , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Sepsis/diagnóstico , Sepsis/fisiopatologíaRESUMEN
The artery of Percheron (AOP) infarction always manifests as paramedian bilateral thalamic infarcts and might present as paramedian midbrain infarcts. Despite the limited MRA evaluation, due to small size of the artery, careful evaluation of the patient's history, the clinical presentation with imaging findings can facilitate the proper diagnosis.