Hsieh C-B, Tzao C, Yu C-Y, Chen C-J, Chang W-K, Chu C-H, Chou S-J, Tung H-J, Yu J-C
Department of Surgery, Division of General Surgery, National Defence Medical Center, Tri-Service General Hospital, 325, Sec. 2, Cheng-Kung Road, 114 Taipei, Taiwan.
Dig Liver Dis. 2006 Jul;38(7):498-502. doi: 10.1016/j.dld.2006.03.020. Epub 2006 May 15.
The Acute Physiology and Chronic Health Evaluation II classification system has been extensively used for predicting the patient mortality in various diseases. However, its utilisation on the pyogenic liver abscess has not yet been well studied.
The purpose of this study was to validate this system on this high death rate disease.
A retrospective study was conducted to assess 314 patients with pyogenic liver abscesses admitted to tertiary medical centre in past 12 years.
The outcome measurement was the in-hospital mortality. A multiple logistic regression model was used to assess the association between mortality and Acute Physiology and Chronic Health Evaluation II score while controlling for the potential confounding factors.
The overall in-hospital mortality was 8.3%. The mean Acute Physiology and Chronic Health Evaluation II score of the expired patients was higher (P<0.0001). The mortality rate increased rapidly when Acute Physiology and Chronic Health Evaluation II score >or=15. After controlling for the potential confounding factors, patient with high admission Acute Physiology and Chronic Health Evaluation II score >or=15 had a higher chance of in-hospital mortality (P<0.01). In addition, the primary liver cancer history is also a risk factor (P=0.03).
The Acute Physiology and Chronic Health Evaluation II score and the primary liver cancer history predict the in-hospital mortality of the pyogenic liver abscess patient.
急性生理与慢性健康状况评估II(APACHE II)分类系统已被广泛用于预测各种疾病患者的死亡率。然而,其在肝脓肿中的应用尚未得到充分研究。
本研究旨在验证该系统在这种高死亡率疾病中的有效性。
进行一项回顾性研究,评估过去12年入住三级医疗中心的314例肝脓肿患者。
观察指标为住院死亡率。采用多元逻辑回归模型评估死亡率与APACHE II评分之间的关联,同时控制潜在的混杂因素。
总体住院死亡率为8.3%。死亡患者的平均APACHE II评分更高(P<0.0001)。当APACHE II评分≥15分时,死亡率迅速上升。在控制潜在的混杂因素后,入院时APACHE II评分≥15分的患者住院死亡风险更高(P<0.01)。此外,原发性肝癌病史也是一个危险因素(P=0.03)。
APACHE II评分和原发性肝癌病史可预测肝脓肿患者的住院死亡率。