目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分...目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.展开更多
Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A tot...Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.展开更多
目的构建基于急性生理学与慢性健康状况评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)评分的脓毒症患者28d死亡风险列线图预测模型,并验证其预测性能,为临床精准评估和风险分层提供辅助工具。方法回顾性纳入2023...目的构建基于急性生理学与慢性健康状况评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)评分的脓毒症患者28d死亡风险列线图预测模型,并验证其预测性能,为临床精准评估和风险分层提供辅助工具。方法回顾性纳入2023年1月至2025年6月在商丘市第一人民医院重症监护室确诊为脓毒症的186例患者,收集患者APACHEⅡ评分相关指标、乳酸水平、基础疾病、机械通气等临床资料,记录28d生存结局。采用多因素Logistic回归分析筛选独立危险因素,并构建列线图模型,通过C指数、校准曲线与决策曲线分析(Decision Curve Analysis,DCA)评估模型的判别力、校准度与临床效用,并行内部Bootstrap验证。根据入组时间将患者分为建模队列(2023年1月至2024年12月,n=138)和时间外推验证队列(2025年1月至2025年6月,n=48),进一步验证模型的稳健性。结果多因素Logistic回归分析显示,APACHEⅡ评分、乳酸水平、机械通气及合并糖尿病/心衰为影响脓毒症患者28d死亡的独立因素(P<0.05)。构建的列线图模型C指数为0.872,校准曲线拟合良好,DCA显示具有较高临床净收益。内部验证C指数为0.860,提示模型稳定性良好。时间外推验证队列中,C指数为0.852。结论基于APACHE II评分的列线图模型可准确预测脓毒症患者28d死亡风险,具有良好的判别能力、校准一致性和临床实用性,适用于临床早期风险评估与干预决策。展开更多
文摘目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.
文摘Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.
文摘目的构建基于急性生理学与慢性健康状况评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)评分的脓毒症患者28d死亡风险列线图预测模型,并验证其预测性能,为临床精准评估和风险分层提供辅助工具。方法回顾性纳入2023年1月至2025年6月在商丘市第一人民医院重症监护室确诊为脓毒症的186例患者,收集患者APACHEⅡ评分相关指标、乳酸水平、基础疾病、机械通气等临床资料,记录28d生存结局。采用多因素Logistic回归分析筛选独立危险因素,并构建列线图模型,通过C指数、校准曲线与决策曲线分析(Decision Curve Analysis,DCA)评估模型的判别力、校准度与临床效用,并行内部Bootstrap验证。根据入组时间将患者分为建模队列(2023年1月至2024年12月,n=138)和时间外推验证队列(2025年1月至2025年6月,n=48),进一步验证模型的稳健性。结果多因素Logistic回归分析显示,APACHEⅡ评分、乳酸水平、机械通气及合并糖尿病/心衰为影响脓毒症患者28d死亡的独立因素(P<0.05)。构建的列线图模型C指数为0.872,校准曲线拟合良好,DCA显示具有较高临床净收益。内部验证C指数为0.860,提示模型稳定性良好。时间外推验证队列中,C指数为0.852。结论基于APACHE II评分的列线图模型可准确预测脓毒症患者28d死亡风险,具有良好的判别能力、校准一致性和临床实用性,适用于临床早期风险评估与干预决策。
