Pollak A J, Strong R M, Gribbon R, Shah H
Gastroenterology Section, Jerry L. Pettis Memorial Veteran's Administration Hospital, Loma Linda, California 92357.
JPEN J Parenter Enteral Nutr. 1991 May-Jun;15(3):313-5. doi: 10.1177/0148607191015003313.
The APACHE II score predicts mortality in severely ill patients. This score does not account for the serum albumin level. Ninety-three patients (28 with serum albumin levels less than 2.5 g/dL [group I] and 65 with serum albumin levels greater than or equal to 2.5 [group II]) were retrospectively reviewed. Patients were comparable in age, APACHE II score, and compliance with required protein needs. Patients with severe hypoalbuminemia had nearly double the death rate of patients with mildly low or normal albumin concentrations (54% compared with 29%). The death rate in the severely hypoalbuminemic patients was 5.1-fold higher than would be predicted by their APACHE II score. The death rate in those patients with mildly low or normal albumin levels had only a 1.9-fold higher rate than would be predicted by their APACHE II score. It is concluded that severe hypoalbuminemia increases the risk of death significantly higher than would be predicted by the APACHE II score. APACHE II score is not as accurate in a severely hypoalbuminemic population.
急性生理学及慢性健康状况评分系统（APACHE II）可预测重症患者的死亡率。该评分未将血清白蛋白水平考虑在内。对93例患者进行了回顾性研究（28例血清白蛋白水平低于2.5 g/dL [第一组]，65例血清白蛋白水平大于或等于2.5 [第二组]）。患者在年龄、APACHE II评分以及蛋白质需求的依从性方面具有可比性。严重低白蛋白血症患者的死亡率几乎是白蛋白浓度轻度降低或正常患者的两倍（分别为54%和29%）。严重低白蛋白血症患者的死亡率比根据其APACHE II评分预测的死亡率高5.1倍。白蛋白水平轻度降低或正常的患者死亡率仅比根据其APACHE II评分预测的死亡率高1.9倍。研究得出结论，严重低白蛋白血症显著增加死亡风险，高于APACHE II评分所预测的风险。在严重低白蛋白血症人群中，APACHE II评分的准确性较低。
