APACHEⅡ评分系统在神经系统危重症患者预后评估中的应用  

The application of APACHEⅡ score system in the nervous system to assess prognosis of critically ill patients

作　　者：谢晖[1] 陈律[2] 徐明[2] 张川[1] 

机构地区：[1]成都市第三人民医院ICU,四川成都610031 [2]首都医科大学附属北京天坛医院ICU,北京100061

出　　处：《四川医学》2010年第3期307-309,共3页Sichuan Medical Journal

摘　　要：目的探讨APACHEⅡ评分系统在神经危重症患者预后评估中的应用价值。方法54例神经危重症患者纳入研究。所有患者在入ICU24h内进行APACHEⅡ评分,评分以各项指标最差值计算。按照预后分为死亡组和生存组,以13分为界,将患者分为低分组(≤13分)和高分组(>13分)。结果本组有15例患者死亡,其余39例存活。死亡组APACHEⅡ评分(18±2.10),存活组(9.95±3.55),两组比较P<0.05。低分组42例,病死率14.3%;高分组12例,病死率75.0%,两组比较P<0.05。对APACHEⅡ分值和预后做相关性分析,r=-0.664,P<0.05。对APACHEⅡ分值和预后做Logistic回归分析,r=0.437,95%可信区间(0.271,0.705),P<0.05。构筑出ROC曲线,曲线下面积为0.89。结论APACHEⅡ评分系统可以较为准确地判断患者的预后。Objective To investigate the value of APACHEⅡ score system in the nervous system to assess prognosis of critically ill patients.Methods The 54 patients were involved.All patients were scored by the worst index level in the APACHEⅡ score system within 24 hour after admission.the patients were separated into dead group and living group according to their prognosis.And they were separated into high score group（〉13） and low score group（≤13） according to the score of APACHEⅡ scores.Results 15 patients die,and another 39 patients were living.The score of dead group was（18±2.10）,and the living group was（9.95±3.35）,P〈0.05.42 patients were in low score group,and their mortality was 14.3%,12 patients were high scored,their mortality was 75.0%,P〈0.05.The correlation analysis between the score and prognosis were performed,r=-0.644,P〈0.05.The Logistics analysis showed r=0.437,95%CI（0.271,0.705）,P〈0.05,To construct the ROC curve,the area under the ROC curve was 0.89.Condusion The APACHEⅡ score system was effective in assessing the prognosis of critically ill patients in nervous system.

关 键 词：APACHEⅡ 预后 神经系统 

分 类 号：R459.7[医药卫生—急诊医学]