摘要
目的:分析ICU危重病患者预后与APACHEⅡ评分变化率的关系。方法:采用前瞻性研究方法,选取ICU的危重病患者634例,按28 d生存率分成生存组(493例)与死亡组(141例),比较2组第1天APACHEⅡ(APACHEⅡ1),第2天APACHEⅡ(APACHEⅡ2)及APACHEⅡ变化率的差异。结果:2组APACHEⅡ1、APACHEⅡ2、APACHEⅡ变化率差异有显著统计学意义(P<0.01)。APACHEⅡ1与APACHEⅡ变化率显著正相关(r=0.104,P=0.009),与预后显著正相关(r=0.296,P=0.000),APACHEⅡ变化率与预后显著负相关(r=-0.352,P=0.000)。APACHEⅡ1和APACHEⅡ变化率ROC下面积分别为0.303、0.742。APACHEⅡ变化率的截断点为0.19(敏感性99%,特异性92%)。结论:APACHEⅡ变化率对ICU危重病患者的预后判断有一定的临床价值。
Objective： To analyze the relationship between the prognosis and the variability of APACHEⅡ scores of critically ill patients in ICU. Methods： A perspective study was conducted in 634 critically ill patients in ICU,they were divided into survival group（ 493 cases） and death group（ 141 cases） according to the survival rate in 28 days. The differences of APACHEⅡ at the first day（ APACHEⅡ1）,APACHEⅡ at the second day（ APACHEⅡ2） and the variability of APACHEⅡwere compared between the two groups. Results： There were significant differences on APACHEⅡ1,APACHEⅡ2 and the variability of APACHEⅡbetween both groups（ P〈0. 01）. APACHEⅡ1 was positively correlated with the variability of APACHEⅡ（ r = 0. 104,P = 0. 009） and prognosis（ r = 0. 296,P = 0. 000）. The variability of APACHE Ⅱ correlated with prognosis negatively（ r =- 0. 352,P = 0. 000）. The areas under the ROC curve of APACHEⅡ1 and the variability of APACHEⅡwere 0. 303 and 0. 742 respectively. The cut off value of the variability of APACHEⅡ was 0. 19（ sensitivity of99%,specificity of 92%）. Conclusion： The variability of APACHEⅡhad a certain clinically value for predicting the prognosis of critically ill patients in ICU.
出处
《内科急危重症杂志》
2015年第6期435-436,444,共3页
Journal of Critical Care In Internal Medicine
基金
江苏省常熟市卫生局2013年指导性项目
