牛津急性疾病严重程度评分和生理评分系统对ICU患者病情评估的价值  

Value of Oxford Acute Severity of Illness Score and Physiological Scoring System in assessment of severity of critical care patients

作　　者：程金霞[1] 方思维 李翔 徐芳媛[1] 李超 CHENG Jiwcia;FANG Siwei;LI Xiang(ICU,the People＇s Hospital of Huangshan Affilated Wannan Medical College,Huangshan 245000,China)

机构地区：[1]皖南医学院附属黄山市人民医院重症医学科,安徽黄山245000

出　　处：《安徽医学》2018年第9期1082-1084,共3页Anhui Medical Journal

摘　　要：目的探讨牛津急性疾病严重程度评分(OASIS)和生理评分系统(PSS)在ICU患者病情评估和预后判断中的价值。方法回顾性分析2016年8月至2017年8月在黄山市人民医院ICU住院的102例重症患者的临床资料,根据转归情况分为好转组(72例)与死亡组(30例),比较两组患者的OASIS和PSS评分,计算OASIS和PSS评分的受试者工作特征(ROC)曲线下面积。结果好转组患者OASIS、PSS评分、机械通气时间分别为(24. 64±5. 95)分、(4. 18±2. 36)分和(3. 36±3. 97) d,死亡组患者为(34. 60±7. 17)分、(6. 47±2. 66)分和(8. 13±9. 36) d,两组差异有统计学意义(P <0. 05)。OASIS的ROC曲线下面积为0. 856(95%CI:0. 770~0. 942,P <0. 05),评分为30. 5分时Youden指数最大,为0. 592。PSS评分的ROC曲线下面积为0. 747(95%CI:0. 637~0. 858,P <0. 05),评分为5. 5分时Youden指数最大,为0. 421。结论 OASIS对ICU患者的病情评估与预后优于PSS评分。Objective To explore the value of Oxford Acute Severity of Illness Score （ OASIS） and Physiological Scoring System （PSS） in evaluating the severity and prognosis of critical care patients. Methods A total ofl02 patients admitted to our ICU from August 2016 to August 2017were retrospectively analyzed,among them 30 were in non - survivors group and 72in survivors group. OASIS,PSS and the area under the receiver operating characteristic（ ROC） in survivors and non - survivors were calculated. Results OASIS, PSS score and duration of mechanical ventilation of survivors group were（24.64 ±5.95）, （4 .1 8 ±2. 36） and（3.36 ± 3 .9 7 ）d respectively, those of non _ survivors group were（34.60 ±7.17） ,（6.47 ±2.66） and（8.13 ±9.36）d, respectively, and there wasstatistically significant difference be- tween the two groups（P 〈0.05）. The area under the ROC of OASIS was 0. 856（95%Cl 0.770 ~ 0 .942, P 〈 0 .0 5 ） , Youden index wasthe biggest,namely 0. 592, when OASIS was 30. 5. The area under the ROC of PSS score was 0. 747 （ 95% Cl ： 0. 637 ~ 0. 858, P 〈 0 .05 ） , Youden index was the biggest,namely 0.421 ,when PSS score was 5.5. Conclusion Oxford Acute Severity of Illness Score is useful in eval-uating the severity and prognosis of critical care patients and superior to PSS.

关 键 词：重症患者 牛津急性疾病严重程度评分 生理评分系统 病情评估 预后 

分 类 号：R459.7[医药卫生—急诊医学]