重症监护室(intensive care unit,ICU)患者病情预测对帮助医生制定医疗方案、配置医疗资源、评估医疗效果具有重要意义。本文从临床和机器学习两个领域介绍了国内外ICU患者病情预测方法的研究和应用进展,主要包括急性生理和慢性健康状...重症监护室(intensive care unit,ICU)患者病情预测对帮助医生制定医疗方案、配置医疗资源、评估医疗效果具有重要意义。本文从临床和机器学习两个领域介绍了国内外ICU患者病情预测方法的研究和应用进展,主要包括急性生理和慢性健康状况评分(acute physiology and chronic health evaluation,APACHE)、简明急性生理功能评分(simplified acute physiology score,SAPS)、逻辑回归、贝叶斯、人工神经网络、支持向量机(support vector machine,SVM)和Adaboost等方法,分析了各种方法的预测模型、预测结果和不足,并对ICU患者病情预测方法的未来发展趋势进行展望。展开更多
BACKGROUND: Because of the complicated pathological features after liver transplantation, severe sepsis is difficult to treat and often leads to death. This study was undertaken to analyze the role of orthotopic liver...BACKGROUND: Because of the complicated pathological features after liver transplantation, severe sepsis is difficult to treat and often leads to death. This study was undertaken to analyze the role of orthotopic liver transplantation (OLT) in patients with severe sepsis and to evaluate the effect of the scoring system. METHODS: Fifty-six patients conformed to the inclusion criteria. They were divided into two groups: non-OLT group (group A) and OLT group (group B). Besides the general data of the patients, the surveillance of blood lactate, the number of failed organs, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and mutiple organ dysfunction score (MODS) were evaluated at the 1st, 3rd and 7th day after OLT. RESULTS: The mortality during hospitalization was 30% in the non-OLT group and 57.6% in the other group. The level of blood lactate at the 1st day of OLT increased more significantly in the OLT group than in the non-OLT group (P<0.01). It was decreased but higher than that in the non-OLT group in the seven days after OLT. The number of failed organs in the OLT group was greater than that in the non-OLT group (P<0.01). The continuous score of APACHEⅡwas not significantly different in the two groups. But the continuous MODS in the OLT group was higher than that in the non-OLT group (P<0.01), which was consistent with the number of failed organs. CONCLUSIONS: The persistently higher level of blood lactate during 7 days may be a dependent risk factor. Immunosuppression may be another risk factor for OLT patients. The mortality of OLT in patients with severe sepsis in 28 days is almost double that in non-OLT patients. The MODS score is better than the APACHEⅡscore in the assessment of organ failure in OLT patients with severe sepsis. The standard scoring system could be improved or a new scoring system that includes the blood lactate score should be established for liver transplantation.展开更多
文摘重症监护室(intensive care unit,ICU)患者病情预测对帮助医生制定医疗方案、配置医疗资源、评估医疗效果具有重要意义。本文从临床和机器学习两个领域介绍了国内外ICU患者病情预测方法的研究和应用进展,主要包括急性生理和慢性健康状况评分(acute physiology and chronic health evaluation,APACHE)、简明急性生理功能评分(simplified acute physiology score,SAPS)、逻辑回归、贝叶斯、人工神经网络、支持向量机(support vector machine,SVM)和Adaboost等方法,分析了各种方法的预测模型、预测结果和不足,并对ICU患者病情预测方法的未来发展趋势进行展望。
文摘BACKGROUND: Because of the complicated pathological features after liver transplantation, severe sepsis is difficult to treat and often leads to death. This study was undertaken to analyze the role of orthotopic liver transplantation (OLT) in patients with severe sepsis and to evaluate the effect of the scoring system. METHODS: Fifty-six patients conformed to the inclusion criteria. They were divided into two groups: non-OLT group (group A) and OLT group (group B). Besides the general data of the patients, the surveillance of blood lactate, the number of failed organs, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and mutiple organ dysfunction score (MODS) were evaluated at the 1st, 3rd and 7th day after OLT. RESULTS: The mortality during hospitalization was 30% in the non-OLT group and 57.6% in the other group. The level of blood lactate at the 1st day of OLT increased more significantly in the OLT group than in the non-OLT group (P<0.01). It was decreased but higher than that in the non-OLT group in the seven days after OLT. The number of failed organs in the OLT group was greater than that in the non-OLT group (P<0.01). The continuous score of APACHEⅡwas not significantly different in the two groups. But the continuous MODS in the OLT group was higher than that in the non-OLT group (P<0.01), which was consistent with the number of failed organs. CONCLUSIONS: The persistently higher level of blood lactate during 7 days may be a dependent risk factor. Immunosuppression may be another risk factor for OLT patients. The mortality of OLT in patients with severe sepsis in 28 days is almost double that in non-OLT patients. The MODS score is better than the APACHEⅡscore in the assessment of organ failure in OLT patients with severe sepsis. The standard scoring system could be improved or a new scoring system that includes the blood lactate score should be established for liver transplantation.
