Xiao Jun, Zhong Rong, Ye Gui-shan
Intensive Care Unit, Affiliated Hospital of Guilin Medical College, Guilin541001, Guangxi, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006 Dec;18(12):743-7.
To compare and evaluate the prognostic value of three prognostic systems namely acute physiology and chronic health evaluation II(APACHEII), simplified acute physiology score II(SAPSII), and Logistic organ dysfunction system (LODS),to predict mortality rate in intensive care unit (ICU).
APACHEII, SAPSII and LODS were used to assess probabilities of hospital mortality rate and to compare with actual outcome. The overall goodness-of-fit of three prognostic systems were assessed by using the areas under the receiver operating characteristic (ROC) curves and classification tables. Calibration curves and Lemeshow-Hosmer chi square statistics were used to test accuracy of prediction.
Hospital mortality rate was basically equivalent to that predicted by APACHEII but higher than those predicted by SAPSII and LODS. The areas under the ROC curves were 0.881 for APACHEII, 0.904 for SAPSII and 0.875 for LODS, and 95% confidence interval (CI) were 0.858-0.904,0.884-0.924 and 0.851-0.898, respectively.The overall correct classification rates, applying the decision criterion of 50%, were 81.60% for APACHEII, 82.09% for SAPSII and 79.26% for LODS. Calibration of APACHEII(chi (2)=9.69) and SAPSII (chi (2)=13.50) were superior to that of LODS (chi (2)=87.22).
The prognostic value of discrimination for APACHEII, SAPSII and LODS is good and basically equivalent, but calibration of acuity of APACHEII and SAPSII is much better than that of LODS.
比较并评估急性生理与慢性健康状况评分系统II（APACHEII）、简化急性生理学评分II（SAPSII）和逻辑器官功能障碍系统（LODS）这三种预后系统预测重症监护病房（ICU）死亡率的预后价值。
使用APACHEII、SAPSII和LODS评估医院死亡率的概率，并与实际结果进行比较。通过受试者工作特征（ROC）曲线下面积和分类表评估三种预后系统的整体拟合优度。使用校准曲线和Lemeshow-Hosmer卡方统计量检验预测准确性。
医院死亡率基本等同于APACHEII预测的死亡率，但高于SAPSII和LODS预测的死亡率。APACHEII的ROC曲线下面积为0.881，SAPSII为0.904，LODS为0.875，95%置信区间（CI）分别为0.858 - 0.904、0.884 - 0.924和0.851 - 0.898。应用50%的决策标准，总体正确分类率APACHEII为81.60%，SAPSII为82.09%，LODS为79.26%。APACHEII（χ² = 9.69）和SAPSII（χ² = 13.50）的校准优于LODS（χ² = 87.22）。结论：APACHEII、SAPSII和LODS的鉴别预后价值良好且基本相当，但APACHEII和SAPSII的敏锐度校准远优于LODS。
