摘要
目的 :应用急性生理学与慢性健康状况评分 (APACHE )评价外科 ICU(SICU)中患者的病情危重程度并判断其预后 ,以证明其在 SICU中应用的有效性。方法 :连续观察入 SICU资料完整患者 15 0例 ,分别计算各自 APACHE 评分及预计病死率 ,并进行验证。结果 :15 0例患者的 APACHE 评分范围 0～ 31分 ,平均 (11.0 2± 7.4 3)分 ;生存 132例评分 (9.5 5± 6 .18)分 ,死亡 18例评分 (2 1.78± 7.0 7)分 ,差异显著 (P<0 .0 1)。APACHE 评分与实际病死率间呈显著正相关 (r=0 .72 ,P<0 .0 1)。 APACHE 评分与预计病死率间呈显著正相关 (r=0 .78,P<0 .0 1)。APACHE 分值以 5分阶增加 ,实际及预计病死率亦增加 ,且 APACHE 评分大于 2 0分时预计与实际病死率均明显升高 ,提示预后较差。在 APACHE 评分低分值段阳性率偏低 ,高分值段敏感性又降低。结论 :1APACHE 评分系统可应用于 SICU作为评估患者危重程度及预后的重要指标。 2通过分析预计与实际病死率间的差异 ,可客观地评价 SICU的医疗及监护质量。3APACHE 评分可为合理利用SICU资源及开展学术交流提供参考。 4 APACHE 评分在预测
Objective:To use acute physiology and chronic health evaluationⅡ(APACHEⅡ) to assess the severity of the illness and prognosis of the critically ill patients in the SICU,and assess the prognostic value of this score system in the surgical ICU(SICU).Methods:One hundred and fifty patients who were admitted to SICU were observed continuously,then APACHEⅡ score was calculated,and predicition of hospital mortality was made individually,finally the prognostic value of this system was assessed.Results:APACHEⅡ scores of these patients were in the range of 0 to 31,average(11 02±7 43),with average score of (9 55±6 18) for 132 survivors and (21 78±7 07) for nonsurvivors.The difference between these two groups of patients was significant ( P <0 01).There was a significant correlation between APACHEⅡ score and actual mortality ( r =0 72, P <0 01),and predicted mortality ( r =0 78, P <0 01).Actual and predicted mortality increased along with the increase in APACHEⅡ scores by 5 scores.When the scores was higher than 20,both actual and predicted mortality increased more significantly.These suggested poorer prognosis.The positive rate was low at low APACHEⅡ score,but the sensitivity was also low with high APACHEⅡ score.Conclusions:① APACHEⅡ score system can be used to predict the prognosis of SICU patients.②The difference between predicted mortality and actual mortality can be used to survey the quality of medical care.③On the basis of APACHEⅡ score system SICU′s resource can be used rationally and academic intercourse can proceed effectively.④There is a limitation in prognostic value for APACHE in SICU patients.
出处
《中国危重病急救医学》
CAS
CSCD
2002年第5期308-310,共3页
Chinese Critical Care Medicine
