智能计算法评估ICU患者部分住院风险指标的研究  

Study of hospitalization risk indicators for intensive care unit patients evaluated by intelligent calculation method

作　　者：侯晓明 陈小玉 杨万杰[1] 康波 孟祥飞 张森乐 冯庆国[1] 刘晓智[1] 张海燕[1] 王骏飞[1] 宋迎[1] 程秀玲[1] 滕洪云 Hou Xiaoming;Chen Xiaoyu;Yang Wanjie;Kang Bo;Meng Xiangfei;Zhang Senle;Feng Qingguo;Liu Xiaozhi;Zhang Haiyan;Wang Junfei;Song Ying;Cheng Xiuling;Teng Hongyun(Department of Critical Care Medicine,the Fifth Center Hospital in Tianjin,Tianjin 300450,China;Sino Singapore Tianjin Eco-city Community Health Service Center in Tianjin,Tianjin 300457,China;National Super Computer Center in Tianjin,Tianjin 300457,China)

机构地区：[1]天津市第五中心医院重症医学科,天津300450 [2]中新天津生态城社区卫生服务中心,天津300457 [3]国家超级计算天津中心,天津300457

出　　处：《中华危重病急救医学》2022年第12期1315-1319,共5页Chinese Critical Care Medicine

基　　金：天津市卫生健康科技项目(ZC20034)。

摘　　要：目的探讨重症监护病房(ICU)患者住院期间各风险评分的变化特点, 旨在为ICU患者的风险预防提供依据。方法采用回顾性研究方法, 选择2021年11月3日至2022年3月28日天津市第五中心医院的ICU住院患者, 按照ICU住院时间分为≥14 d组、10~13 d组、7~9 d组、3~6 d组。收集患者ICU住院期间由智能计算法评估的营养风险筛查2002量表(NRS 2002)评分, 以及评估静脉血栓栓塞症(VTE)风险的Caprini评分和Padua评分, 选取所有患者的NRS 2002评分、手术患者的Caprini评分、非手术患者的Padua评分。比较患者入ICU 1、3、7(如果需要)、10(如果需要)、14 d(如果需要)时各项评分的变化趋势。结果最终纳入138例ICU患者, 其中男性79例, 女性59例;平均年龄(61.71±18.86)岁;中位ICU住院时间6.00(4.00, 9.25)d。① ICU住院时间≥14 d组(21例):入ICU 10 d内患者NRS 2002评分无明显变化, 入ICU 14 d时NRS 2002评分较入ICU 1 d时明显降低〔分:3.00(2.50, 3.50)比4.00(3.00, 5.00), P<0.05〕;随住院时间延长, Caprini评分和Padua评分均呈升高趋势, 且各时间点血栓风险评分均明显高于入ICU 1 d时, 以入ICU 14 d最明显〔Caprini评分(分):5.00(3.25, 7.00)比2.50(1.25, 5.50), Padua评分(分):6.00(6.00, 7.00)比3.00(1.00, 3.00), 均P<0.05〕。② ICU住院时间10~13 d组(15例):随住院时间延长, NRS 2002评分无明显变化, Caprini评分和Padua评分均呈升高趋势, 且患者入ICU 3、7、10 d时血栓风险评分均明显高于入ICU 1 d时, 以入ICU 10 d最明显〔Caprini评分(分):3.00(2.00, 4.75)比2.00(0.25, 2.75), Padua评分(分):5.00(3.50, 6.00)比2.00(0.50, 4.00), 均P<0.05〕。③ ICU住院时间7~9 d组(23例):与入ICU 1 d比较, 患者入ICU 3 d和7 d时NRS 2002评分呈不同程度降低, Caprini评分和Padua评分均呈不同程度升高, 以入ICU 7 d最明显〔NRS 2002评分(分):2.00(1.00, 4.00)比2.00(2.00, 4.00), Caprini评分(分):3.00(2.00, 5.50)比2.00(0.25, 3.00), Padua评分(分):5.00(4.00, 6Objective To explore the characteristics of the changes in risk score for intensive care unit(ICU)patients during hospitalization by the intelligent calculation method,and to provide evidence for the risk prevention.Methods In this retrospective study,ICU patients of the Fifth Central Hospital in Tianjin from November 3,2021 to March 28,2022 were enrolled and divided into≥14 days group,10-13 days group,7-9 days group,and 3-6 days group according to the ICU length of stay.Risk scores assessed by the intelligent calculation method of the ICU patients were collected,including nutritional risk screening 2002(NRS 2002),Caprini score and Padua score.NRS 2002 score for all patients,Caprini score for surgical patients and Padua score for internal medicine patients were selected.Trends in change of each score were compared between patients admitted to ICU 1,3,7(if necessary),10(if necessary),and 14 days(if necessary).Results A total of 138 patients were involved,including 79 males and 59 females,with an average age of(61.71±18.86)years and an average hospital stay of[6.00(4.00,9.25)]days.①in the group with ICU length of stay≥14 days(21 cases):there was no significant change in the NRS 2002 scores of the patients within 10 days,but the NRS 2002 score was significantly decreased in 14 days as compared with 1 day[3.00(2.50,3.50)vs.4.00(3.00,5.00),P<0.05];both Caprini and Padua score were increased with prolonged hospital stay and compared with 1 day,the scores at the other time points were significantly increased,especially at 14 days[Caprini score:5.00(3.25,7.00)vs.2.50(1.25,5.50),Padua score:6.00(6.00,7.00)vs.3.00(1.00,3.00),both P<0.05].②in the group with ICU length of stay from 10-13 days(15 cases):with the prolonged hospital stay,there was no significant change in NRS 2002 score,but both Caprini and Padua score were increased at 3,7,10 days,especially at 10 days[Caprini score:3.00(2.00,4.75)vs.2.00(0.25,2.75),Padua score:5.00(3.50,6.00)vs.2.00(0.50,4.00),both P<0.05].③in the group with ICU length of stay from

关 键 词：重症监护病房 风险评分 智能计算法 营养风险筛查2002 Caprini评分 Padua评分 

分 类 号：R459.7[医药卫生—急诊医学]