重症医学科三种危重评分之间的相关性研究  

The study of predictive power and correlation of three severity-of-illness scores in intensive care unit

作　　者：邢学忠[1] 曲世宁[1] 黄初林[1] 张昊[1] 王浩 王海军[1] 高勇[1] 孙克林[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院重症医学科,北京100021

出　　处：《临床急诊杂志》2015年第5期355-357,361,共4页Journal of Clinical Emergency

摘　　要：目的：研究目前常用的三种评分SAPS 3、APACHEⅡ和APACHEⅣ对重症患者的预测效力、相关性。方法：前瞻性收集中国医学科学院肿瘤医院重症医学科（ICU）2008-10-2010-09收治的全部患者的资料。通过受试者工作曲线（ROC）显示三种评分预测ICU患者28d病死率的能力。通过Bivariate分析比较三种评分的相关性。结果：981例患者进入最后的分析。三种评分能很好地预测危重患者28d病死率。SAPS 3,AUC=0.948（95%CI 0.914~0.982,P〈0.01）;APACHEⅡ,AUC=0.863（95%CI 0.804~0.923,P〈0.01）;APACHEⅣ,AUC=0.873（95%CI0.813~0.934,P〈0.01）。相关分析发现SAPS 3、APACHEⅡ、APACHEⅣ三种评分之间明显相关（R2：0.514~0.705,P〈0.01）。结论：三种评分对于ICU患者的28d病死率的预测能力相当。三种预后评分方面存在明显的相关性。Objective： To study the predictive power of three severity-of-illness scores （acute physiology and chronic health evaluation Ⅱ ,APACHE U ;Simplified Acute Physiology Score 3, SAPS 3and Acute Physiology and Chronic Health Evaluation IV ,APACHEIV） by receiver operating curves in predicting 28-day mortality of critical- ly ill patients, the correlation of three scores （APACHE Ⅱ ;SAPS 3 and APACHE IV）. Method： Data of all patients admitted to intensive care unit of Cancer Hospital, Chinese Academy of Medical Sciences between October 2008 and September 2010 were retrospectively reviewed and analyzed. Receiver operating curves were used to assess the dis- crimination power in predicting 28-day mortalityof all three scores. Bivariate analysis was used to assess the corre- lation of three predictive scores. Result：981 patients enrolled into the final analysis. All three scores predicted 28- day mortality well by means of receiver operating curves. The area under the curve was 0. 948 （95% CI 0. 914- 0. 982,P〈0.01） for SAPS 3,0. 863 （95% CI 0. 804-0. 923,P〈0.01） for APACHEⅡ ,and 0. 873 （0. 813-0. 934, P〈0.01） for APACHEIV. Bivariate analysis showed that three scores correlated well （the R square is between 0. 514 and 0. 705 ,P〈0.01 ）. Conclusion： All three predictive scores had good discrimination power in predicting 28- day mortality in intensive care unit.

关 键 词：重症医学科 预后 危重评分 

分 类 号：R449[医药卫生—诊断学]