[qSOFA score for prediction of outcome in surgical patients in intensive care units. Post hoc analysis of the Russian multi-center trial Rises]. / Ispol'zovanie shkaly qSOFA v prognoze iskhoda lecheniya u khirurgicheskikh patsientov v orit. Subpopulyatsionnyi analiz materialov issledovaniya RISES.

OBJECTIVE: To define the informative value of qSOFA score in the prediction of outcomes in surgical patients admitted to the Intensive Care Units. STUDY DESIGN: Post hoc analysis of multicenter prospective observational study RISES. The following patient information was analyzed: gender, age, diagnosis, presence of infection, SIRS criteria, qSOFA and SOFA scores, outcomes. RESULTS: The study included data of 331 patients with surgical diseases. Infection was not observed in 174 (52.6%) cases, 157 (47.4%) patients had infection. In the group of patients without infection, area under ROC-curve for SIRS criteria was 0.519 (95% CI 0.429-0.610) and similar to that qSOFA (p=0.535). Area under ROC-curve for SOFA scale was 0.619 (95% CI 0.511-0.726) and did not significantly differ from this value for QSOFA (p=0.241). In the group of surgical patients with infection, area under ROC-curve for SIRS was 0.490 (95% CI 0.419-0.561), that was significantly lower than area under ROC-curve for qSOFA (p=0.016). Area under ROC-curve for SOFA scale was 0.803 (95% CI 0.681-0.924), that significantly exceeded area under ROC-curve for qSOFA (p=0.017). CONCLUSION: qSOFA scale is important in surgical patients with infection admitted to ICUs. Increased qSOFA score is associated with augmentation of mortality rate. qSOFA scale significantly exceeds the SIRS criteria, but is inferior to the SOFA in the prognosis of mortality in these patients.

CLINICAL CASE OF THE INNATE CENTRAL HYPOVENTILATION SYNDROME IN THE PARTURIENT.

The syndrome "of the curse of Undina" or the innate central hypoventilation syndrome with the second disorder of cen- tral nervous system is the result of the disrupted vegetative control of the respiration in the absence of neuromuscular diseases and disturbances of the mechanics of respiration. In the clinical practice diagnostics of this state is complex, frequently the cases remain not diagnosed. Taking into account clinical manifestations and depending on the degree of their intensity, early diagnostics, which warns the undesirable consequences ofthe episodes ofhypoxia and hypercapnia, that ensures the proper checking of the episodes of asphyxia, determines not only the forecast of disease, but also life of patient. The purpose ofthis work is the idea of the clinical case of this rarely meeting illness.