敗血症與早期警示評分系統

Sepsis and Early Warning Score Systems

敗血症是造成病人併發症及死亡的重要導因，而搶救敗血症病人生命是全球健康照護領域重要的議題及挑戰。改變敗血症病人預後並降低死亡率之關鍵點在於早期診斷及積極治療處置，隨著2016年敗血症－3定義之重大更新，及2016年敗血症暨敗血性休克臨床照護指引建議，醫療機構應該要建立敗血症篩選的系統，以早期辨識發生敗血症或敗血症高風險的患者，以便提供及時的處理，並且應有建立提高敗血症之照護品質及病人存活率的具體計畫。英國是最早提出警示評分系統的概念，透過彙集病人各項生理參數，作為快速診斷與篩選病情朝向惡化發展的病人，提供臨床人員決策。警示評分系統於敗血症病人的照護扮演相當重要的角色，透過警示系統可早期辨識或是預測相關風險及死亡率，雖然研究的差異性仍存在，然而對於臨床護理人員仍是重要的參考項目。所有智能化系統雖然都不是萬能的，但是若能透過人類智慧結合相關特性，並進一步優化系統，將能更精準的對降低敗血症病人的死亡率做出重大貢獻。

Sepsis is a significant cause of morbidity and mortality worldwide. Early diagnosis and management of sepsis is critical to improving patient prognoses. Surviving sepsis campaign guidelines issued in 2016 encourage health institutions to establish a screening system to identify patients who are at risk of sepsis. In 2012, the Royal College of Physicians in the UK began to advocate replacing local and regional scoring systems with the National Early Warning Score (NEWS), which is optimized for the identification of sepsis. Although many hospitals continue to use other scoring systems, all healthcare organizations are being encouraged to adopt a standardized scoring system to better promote patient safety by facilitating rapid diagnoses and screenings and thus, subsequently, improving decisionmaking by clinical staffs. NEWS plays a very important role in the treatment of sepsis patients. Although research findings related to this scoring system differ somewhat, they provide an important reference for clinical nursing staffs. Intelligent systems are not comprehensive in terms of their capabilities. However, combining human intelligence with system features and further optimizing the system should contribute significantly to the reduction of mortality risk in patients with sepsis.