摘要
目的探讨联合合并症评分(CCS)与查尔森合并症指数(CCI)对老年重症肺炎患者预后的评估价值。方法采用回顾性研究方法,收集ICU收治的老年重症肺炎患者的临床资料,在入院24 h内对患者使用CCS评分、CCI指数、PSI评分及APACHEⅡ评分进行评分,入院后28 d患者生存状态为观察终点,使用受试者工作特征曲线下面积(AUC)评价4种评分系统预测患者预后的价值。结果 106例患者纳入研究,28d病死率41.5%,死亡组的4种评分均高于存活组,差异有统计学意义(P<0.01),CCS评分、CCI指数、PSI评分及APACHEⅡ评分的AUC及95%可信区间分别是0.783(95%CI 0.691~0.859)、0.770(95%CI 0.676~0.848)、0.877(95%CI 0.798~0.934)和0.858(95%CI 0.775~0.919),PSI评分和APACHEⅡ评分的AUC明显大于CCI指数和CCS评分,差异有统计学意义(P<0.05)。CCI指数和CCS评分差异无统计学意义(P>0.05)。结论 CCS评分及CCI指数在评估老年重症肺炎患者的预后中有一定价值。
Objective To investigate combined comorbidity score （CCS） and Charlson comorbidity index （CCI） in the assessment of prognosis of elderly patients with severe pneumonia. Methods A retrospective review of elderly pa- tients with severe pneumonia admitted to ICU was conducted. The CCS, CCI, PSI and APACHE Ⅱ were carried out to within 24 hours of admission. Clinical end point was death in 28 days after hospital admission. The discriminative power of the four scores was evaluated by the area under the receiver operating characteristic curve （AUC）. Results The mortality rate was 41.5% （44/106）. The scores of death group evaluated by CCS, CCI, PSI and APACHE Ⅱ were significantly higher than those of survival group （P 〈0.05）. The AUCs of CCS, CCI, PSI and APACHE Ⅱ were 0.783 （95%CI 0.691-0.859）, 0.770 （95%CI0.676-0.848）, 0.877 （95%CI0.798 -0.934） and 0.858 （95%CI0.775 - 0. 919） , respectively. The AUCs of PSI and APACHE 11 were significantly greater than those of CCS and CCI （P 〈 0. 05 ）. There was no significant difference between the AUCs of CCS and CCI. Conclusion CCS and CCI have predic- tive values on assessing prognosis of elderly patients with severe pneumonia.
出处
《广东医学》
CAS
2018年第3期379-382,共4页
Guangdong Medical Journal
基金
上海市浦东新区卫生系统重点学科建设资助项目(编号:PWZXK2017-20)
上海市浦东医院浦秀计划项目(编号:PX201607)
