APACHEⅡ变化率与ICU危重病患者预后相关性研究
The Correlation Study of the Change Rate of APACHEⅡ and Prognosis in Severe Ill Patients of ICU

方卫刚.APACHEⅡ变化率与ICU危重病患者预后相关性研究[J].内科急危重症杂志,2015,21(6):

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英文关键词:APACHEⅡ The change rate of APACHEⅡ Prognosis

基金项目:江苏省常熟市卫生局2013年指导性项目

作者	单位	E-mail
方卫刚	江苏省常熟市第二人民医院	fang_weigang@sina.com

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中文摘要:

【】目的研究APACHEⅡ变化率与ICU危重病患者预后的相关性。方法采用前瞻性研究方法,选取2013年06月-2014年12月收住本院ICU的危重病例634例,按APACHEⅡ变化率分成两组,比较APACHEⅡ1,APACHEⅡ2,APACHEⅡ变化率的差异。结果两组患者性别、年龄差异无统计学意义(P>0.05)。APACHEⅡ1差异有统计学意义(P<0.05)。APACHEⅡ2、APACHEⅡ变化率差异有显著统计学意义(P<0.01)。APACHEⅡ1与APACHEⅡ变化率显著正相关(r=0.104,P=0.009),与实际预后显著正相关(r=0.296,P=0.000),APACHEⅡ变化率与实际预后显著负相关(r=-0.352,P=0.000)。预测预后与实际预后显著正相关(r=0.365,P=0.000)。APACHEⅡ1和APACHEⅡ变化率ROC下面积分别为0.303、0.742。APACHEⅡ变化率的截断点为0.25(敏感性99%,特异性92%)。结论 APACHEⅡ变化率对ICU危重病患者的预后判断有一定的临床价值,APACHEⅡ变化率能更准确、更早期的预测预后。

英文摘要:

【Abtract】 Objective: To study the correlation of the change rate of APACHEⅡ scores and prognosis in severe ill patients of ICU.Methods: A perspective study was conducted. From June 2013 to December 2014 in our hospital ICU ,634 severe ill patients were divided into two groups according with the change rate of APACHEⅡ.To compare the difference of APACHEⅡof No.1 day, APACHEⅡ of No.2 day and the change rate of APACHEⅡ. Results: No significant differences were found in the items such as age and sex among both groups(P>0.05). There were differences on APACHEⅡof No.1 day between both groups(P<0.05). There were very significant differences on APACHEⅡ of No.2 day and the change rate of APACHEⅡbetween both groups (P<0.01).There were significant correlation between APACHEⅡof No.1 day and the change rate of APACHEⅡ (r=0.104，P=0.009).So was between APACHEⅡof No.1 day and practical prognosis（r=0.296，P=0.000）. The change rate of APACHEⅡ correlated with practical prognosis negatively（r=-0.352，P=0.000）. There were significant correlation between forecast prognosis and practical prognosis（r=0.365，P=0.000）. To compare the area of APACHEⅡof No.1 day and the change rate of APACHEⅡ, their areas under the ROC curve were 0.303 and 0.742.Cut off value of the change rate of APACHEⅡ was 0.25(sensitivity of 99%,specificity of 92%). Conclusion: It was certain clinical value to determine prognosis in severe ill patients of ICU by the change rate of APACHEⅡ.The change rate of APACHEⅡ can foretell prognosis accurater and earlier.