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논문 기본 정보

자료유형
학술저널
저자정보
Lee Dong-Young (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) Ryu Seung (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) Jeon So Young (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) Park Jung Soo (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) You Yeonho (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) Jeong Wonjoon (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea.) Cho Yong Chul (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) 안홍준 (충남대학교병원) Kang Changshin (Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea) Oh Se Kwang (Department of Emergency Medicine, Chungnam National University Sejong Hospital, Sejong, Korea)
저널정보
대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine 제11권 제3호
발행연도
2024.9
수록면
268 - 294 (27page)
DOI
10.15441/ceem.23.125

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Objective: Effective triage of febrile patients in the emergency department is crucial during times of overcrowding to prioritize care and allocate resources, especially during pandemics. However, available triage tools often require laboratory data and lack accuracy. We aimed to develop a simple and accurate triage tool for febrile patients by modifying the quick Sequential Organ Failure Assessment (qSOFA) score.Methods: We retrospectively analyzed data from 7,303 febrile patients and created modified versions of qSOFA using factors identified through multivariable analysis. The performance of these modified qSOFAs in predicting in-hospital mortality and intensive care unit (ICU) admission was compared using the area under the receiver operating characteristic curve (AUROC).Results: Through multivariable analysis, the identified factors were age (“A” factor), male sex (“M” factor), oxygen saturation measured by pulse oximetry (SpO2; “S” factor), and lactate level (“L” factor). The AUROCs of ASqSOFA (in-hospital mortality: 0.812 [95% confidence interval, 0.789–0.835]; ICU admission: 0.794 [95% confidence interval, 0.771–0.817]) were simple and not inferior to those of other more complex models (e.g., ASMqSOFA, ASLqSOFA, and ASMLqSOFA). ASqSOFA also displayed significantly higher AUROC than other triage scales, such as the Modified Early Warning Score and Korean Triage and Acuity Scale. The optimal cutoff score of ASqSOFA for the outcome was 2, and the score for redistribution to a lower level emergency department was 0.Conclusion: We demonstrated that ASqSOFA can be employed as a simple and efficient triage tool for emergency febrile patients to aid in resource distribution during overcrowding. It also may be applicable in prehospital settings for febrile patient triage.

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