序贯器官衰竭评分对急诊危重患者30d病死率的预测价值研究  

Predictive value of SOFA score on 30-day mortality in critically ill patients

作　　者：甘君英 许和平[1] 吴开芳[1] 陈芸妹 叶小娟 Gan Jun-ying;Xu He-ping;Wu Kai-fang;Chen Yun-mei;Ye Xiao-juan(Department of Longhua Emergency,Hainan General Hospital,Haikou 570000,China)

机构地区：[1]海南省人民医院龙华急诊科,海南海口570000

出　　处：《中国急救医学》2019年第1期53-56,共4页Chinese Journal of Critical Care Medicine

基　　金：2017年海南省卫生计生行业科研项目(16A200043).

摘　　要：目的评估序贯器官衰竭评分(SOFA)对急诊危重患者30 d病死率的预测价值。方法收集2016年10月至2017年10月在海南省人民医院急诊科就诊的140例危重患者,采集病史和基本临床特征。根据SOFA评分系统的定义进行评分,最后计算SOFA评分对危重患者30 d病死率的预测价值,评估患者的SOFA评分与病死率之间的关系。结果140例危重患者平均总体SOFA评分为(7.13±2.36)分(最低2分,最高16分),117例(84.12%)得分在4~10分之间。72例(51.43%)在30d内死亡,16例(11.43%)多器官衰竭,6例(4.29%)肾衰竭,1例(0.71%)心力衰竭,9例(6.43%)神经功能受损。SOFA评分预测患者病死率ROC曲线下面积(AUC)为0.73(95%CI 0.65~0.81)。截点值为7以上时SOFA评分对急诊危重患者30 d病死率预测的敏感性和特异性分别为75.00%和63.23%。结论SOFA评分系统在预测急诊危重患者30 d病死率方面具有较好的准确性。Objective To assess the predictive value of SOFA scores for 30-day mortality in critically ill patients in emergencies.Methods The critically ill patients who were admitted to the emergency department of Hainan Provincial People’s Hospital from October 2016 to October 2017 were collected and their medical history and basic clinical characteristics were collected.The scores were determined according to the definition of the SOFA scoring system.Finally,the predicted value of the SOFA score for the 30-day mortality of critically ill patients was calculated,and the relationship between the patient's SOFA score and mortality was evaluated.Results The mean overall SOFA score was(7.13±2.36)points(minimum 2 points,maximum 16 points),and 117(84.12%)patients scored between 4 and 10.72 patients(51.43%)died within 30 days,16 patients(11.43%)had multiple organ failure,6 patients(4.29%)developed renal failure,1 patient(0.71%)had heart failure,and 9 patients(6.43%)had neurological damage.The area under the SOFA score ROC curve predicted a mortality rate of 0.73(95%CI 0.65-0.81).The sensitivity and specificity of SOFA scores for 30-day mortality in critically ill patients were 75.00% and 63.23%,respectively,when the cut-off value was 7 or higher.Conclusion The SOFA scoring system is quite accurate in predicting 30-day mortality in critically ill patients.

关 键 词：序贯器官衰竭评分(SOFA) 急诊危重 病死率 预测 

分 类 号：R459.7[医药卫生—急诊医学]