摘要
目的观察急性生理学及慢性健康状况评价系统(APACHE)Ⅱ和Ⅲ对>75岁内科重症病人预后评价的可靠性。方法对2004年3-9月间收治的年龄>75岁的病人进行入院即刻计算APACHEⅡ/Ⅲ评分和预期病死率,并与实际住院病死率对比。结果APACHEⅡ/Ⅲ得分和预期病死率之间或同实际病死率之间高度相关,APACHEⅡ灵敏度为66.7%,特异度为90.9%,阳性预测值72.7%,阴性预测值88.2%;APACHEⅢ对预后判断的灵敏度为41.7%,特异度为100%,阳性预测值100%,阴性预测值82.5%。结论APACHEⅡ/Ⅲ系统均能判断高龄重症病人预后,但是APACHEⅢ系统对病人住院病死率有低估倾向。
Objective To observe the efficiency of both the APACHE Ⅱ/Ⅲ scoring systems in predicting the prognosis of patients older than 75 years.Methods We calculated both the APACHE Ⅱ and Ⅲ scores in patients older than 75 years who were admitted to the geriatric intensive care unit (GICU) of our hospital in a duration of 6 months. The scores and predicting death rates were compared with the actual death rates. Results There was definite correlation between the APACHE Ⅱ/Ⅲ scores and the actual death rates. Sensitivity of the APACHE Ⅱ/Ⅲ systems are 66.7% and 41.7% respectively. Specificity of the APACHE Ⅱ/Ⅲ systems are 90.9% and 100% respectively. Conclusions Both the APACHE Ⅱ/Ⅲ systems can do well in predicting the prognosis of ICU patients older than 75 years, but APACHE Ⅲ tends to underestimate the hospital death rate of elderly patients.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2005年第4期251-253,共3页
Chinese Journal of Internal Medicine
