重症监护病房产科患者生理改变、年龄及健康(APACHE Ⅲ)评分的应用  

Utility of Acute Physiology,Age,and Chronic Health Evaluation (APACHE Ⅲ) score in maternal admissions to the intensive care unit

作　　者：Stevens T.A. Carroll M.A. Promecene P.A. 柳蕴 

机构地区：[1]Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Medical School,Houston, United States Dr

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2006年第9期18-18,共1页Core Journal in Obstetrics/Gynecology

摘　　要：Objective: Amean Acute Physiology,Age, and Chronic Health Evaluation (APACHE III) score of > 50 is associated with increased intensive care unit mortality rate in nonpregnant cardiac and trauma patients. The objective was to determine the usefulness of the APACHE III score in maternal admissions to an intensive care unit in a tertiary care center in an urban multicul turalcity. Study design: This was a retrospective review of all maternal admissions ( > 20 weeks of gestation or after delivery)- to an intensive care unit between January 2002 and May 2004. Demographics, obstetric and medical history, and 20 physiologic variables that comprise the APACHE III were recorded.The minimum APACHE III score (lowest risk of death) is 0;maximum is 299. The association between APACHE III scoreand maternal death was assessed with Mann Whitney U test.Significance was assumed at a probability value of < .05. Results:Fifty-eight subjects met the study criteria. Thirty percent of these women were admitted antepartum (27 ± 1.0 weeks of gestation); 31% of the women were admitted on the day of delivery; and 29% of the women were admitted after delivery.Mean maternal age was 27 ± 6.7 years. Acute conditions that resulted in transfer to the intensive care unit included preeclampsia(24% ), cardiorespiratory disease (21% ), hemorrhage(16% ), infection (12% ), trauma (7% ), and thromboembolism(3% ). Fifty-five percent of the women had no previous underlying obstetric complications, and 98% of the women had no underlying chronic health condition. Fifty-eight percent of the women received care in a medical intensive care unit; 28% of the women received care in a surgical intensive care unit; 10% of the women received care in a cardiac intensive care unit, and 3% of the women received care in a neurologic intensive care unit. The mean intensive care unit stay was 3.7 ± 4.6 days, and the mean hospital stay was 9.0 ± 7 days. Three patients died; the rest of the patients went home in good condition. The median APACHE III score was 34 (rangeObjective： Amean Acute Physiology, Age, and Chronic Health Evaluation （APACHE Ⅲ） score of 〉 50 is associated with increased intensive care unit mortality rate in nonpregnant cardiac and trauma patients. The objective was to determine the usefulness of the APACHE Ⅲ score in maternal admissions to an intensive care unit in a tertiary care center in an urban multicul turalcity. Study design： This was a retrospective review of all maternal admissions （ 〉 20 weeks of gestation or after delivery） -to an intensive care unit between January 2002 and May 2004. Demographics, obstetric and medical history, and 20 physiologic variables that comprise the APACHE Ⅲ were recorded. The minimum APACHE Ⅲ score （lowest risk of death） is 0; maximum is 299. The association between APACHE Ⅲ scoreand maternal death was assessed with Mann Whitney U test. Significance was assumed at a probability value of 〈. 05. Results： Fifty-eight subjects met the study criteria. Thirty percent of these women were admitted antepartum （27± 1.0 weeks of gestation）; 31% of the women were admitted on the day of delivery; and 29% of the women were admitted after delivery. Mean maternal age was 27 ± 6. 7 years. Acute conditions that resulted in transfer to the intensive care unit included preeclampsia （24%）, cardiorespiratory disease （21%）, hemorrhage （16%）, infection （12%）, trauma （7%）, and thromboembolism（3% ）. Fifty-five percent of the women had no previous underlying obstetric complications, and 98% of the women had no underlying chronic health condition. Fifty-eight percent of the women received care in a medical intensive care unit; 28% of the women received care in a surgical intensive care unit; 10% of the women received care in a cardiac intensive care unit, and 3% of the women received care in a neurologic intensive care unit. The mean intensive care unit stay was 3.7 ± 4. 6 days, and the mean hospital stay was 9. 0 ± 7 days. Three patients died; the rest of the patients went home in

关 键 词：APACHEⅢ评分 神经科重症监护病房 产科患者 平均年龄 生理改变 健康 人口统计学 三级医疗中心 

分 类 号：R714[医药卫生—妇产科学]