摘要
目的：应用年龄评分、慢性健康状况评分（chronichealthyscore，CHS）和基础疾病个数评价基础疾病对危重病患者28d预后的影响。方法：回顾性分析上海长征医院200912—2011-12的危重病患者的临床资料；记录患者的一般状况，计算人院时WIC、CHS和年龄评分、入院后48h内急性生理与慢性健康状况（A—PACHE）评分Ⅱ和脓毒症相关性器官功能衰竭评分（SepsisRelatedOrganFailureAssessment，S（）FA）评分；统计各个变量同预后的关系。结果：共有406名患者纳入研究，与存活组比较，死亡组的基础疾病分值、APACHEⅡ分值和sOFA评分较高，肺炎患者比例较高（P（0．05）。年龄评分和基础疾病评分分值越高，死亡率越高（P〈0．01）。年龄，CHS，基础疾病数，APACHEⅡ，SOFA，联合预测概率的曲线下面积（95％可信区间）分别是：0．634（0．570～0．699），0．540（0．471～0．609），O．651（0．587～0．714），0．786（0．734～0．837），O．787（0．736～0．839），0．817（0．768～0．866）。多因素logistic回归分析显示：年龄评分（（）R一1．188，95％CI：1．030～1．369，P=0．0．018）、基础疾病评分（OR=1．425。95％CI：1．049～1．934，P=0．023）患者28d预后独立相关，CHS（OR=1．127，95％CI：0．849～1．497，p=0．407）并不是28d预后的独立变量。结论：基本健康状况影响危重病患者的预后，基础疾病联合SOFA评分等有助于对lCU患者28d预后的影响。
Objective：We investigated the effects of age and comorbidites on mortality of critical ill patients three scores system：age group socre, chronic healthy score and numbers of co-morbidities. Method： A single-cen- ter,2-year retrospective study was conducted and all ICU patients were included. General data about patients were recorded, scores of age,CHS, numbers of co-morbidities, APACHE and SOFA score were calculated and associa- tions among each other were analyzed statistically. Result：406 patients were enrolled and divided into survival and non-survival group. Compared with survival group, non-survivors had higher scores of co-morbidities,CHS, age and APACHE ,SOFA（P〈0.05）. Patients with high socre of age and co-morbidities had higher mortality. ROC curve area （95 - confidence index） predicting 28 days mortality for age, numbers of co-morbidities,CHS, APACHE H , SOFA and combinations numbers of co-morbidities with APACHE II ：0. 634 （0. 570 - 0. 699 ）, 0. 540 （0. 471 - 0. 609）,0. 651（0. 587-0. 714）,0. 786（0. 734-0. 837）,0. 787（0. 736-0. 839）,0. 817（0. 768-0. 866）,respectively. The multivariate logistic regression revealed that risk of death depends significantly of numbers of co-morbidities （OR=1.425,95- CI：1.049-1.934,P=0.023） and age scores（OR=l. 188,95- CI：1.030-1.369,P=0. 018） ,but not scores of CHS（OR-I. 127,95- CI：0. 849-1. 497,P-0. 407）. Conclusion：Age and chronic health status could affect mortality among critical ill patients.
出处
《临床急诊杂志》
CAS
2014年第2期85-88,共4页
Journal of Clinical Emergency
