摘要
目的比较急性生理评分(APS)与序贯器官衰竭评估评分(SOFA)对高龄脓毒症患者预后预测能力的差异。方法利用美国重症医学领域的公共数据库筛选出高龄(年龄≥80岁)脓毒症患者并分别计算APS与SOFA,以28 d内死亡为主要结局,使用多因素Cox回归分析各评分与预后的关联,同时绘制受试者工作特征(ROC)曲线并比较曲线下面积(AUC)的不同。结果最终共纳入2 936例高龄脓毒症患者,平均年龄为(85. 47±3. 09)岁,28 d内病死率为22. 89%。APS与SOFA均与28 d内死亡显著关联(风险比分别为1. 03与1. 17)。APS与SOFA预测28 d内死亡的ROC曲线下面积分别为0. 68和0. 63,差异有统计学意义(P <0. 01)。结论 APS与SOFA对于高龄脓毒症患者短期预后的预测有一定价值,而APS对28 d内死亡的预测价值优于SOFA。
Objective To compare the value of Acute Physiology Score(APS)and Sequential Organ Failure Assessment Score(SOFA)in evaluation of the prognosis of patients with sepsis.Methods Elderly patients(age≥80 years)with sepsis were screened out from American critical care medicine database.APS and SOFA were calculated,and 28-day mortality was chosen as the primary outcome.Then multivariate Cox regression was used to analyze the association between each score and the outcome,and receiver operating characteristic curve was also drawn to compare the area under the curve(AUC)of each score.Results A total of 2 936 elderly patients with sepsis were included finally,with an average age of(85.47±3.09)years and a 28-day mortality rate of 22.89%.Both APS and SOFA were significantly associated with 28-day mortality(hazard ratios:1.03 and 1.17,respectively).The AUC area of 28-day death by APS and SOFA was 0.677 and 0.633,respectively,and the difference was statistically significant(P<0.01).Conclusion Both APS and SOFA are closely related to the short-term prognosis of elderly patients with sepsis,but the predictive value of APS for 28-day mortality may be better than that of SOFA.
作者
戴盈
秦少云
潘华琴
陈燕华
DAI Ying;QIN Shaoyun;PAN Huaqin;CHEN Yanhua(Department of Respiratory Medicine,Taizhou People′s Hospital,Taizhou,Jiangsu,225300)
出处
《实用临床医药杂志》
CAS
2019年第4期37-40,共4页
Journal of Clinical Medicine in Practice
关键词
急性生理评分
序贯器官衰竭评估评分
脓毒症
高龄
预后
acute physiology score
sequential organ failure assessment score
sepsis
the elderly
prognosis
