Honarmand Azim, Safavi Mohammadreza, Moradi Daruosh
Department of Anesthesiology, Alzahra Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Ulus Travma Acil Cerrahi Derg. 2009 Sep;15(5):440-7.
This study examines the efficacy of two different scoring systems in predicting mechanical ventilation need (MVN) and duration (DMV) in a surgical intensive care unit (ICU).
This prospective observational study included 144 consecutive patients admitted to the ICU for more than 24 hours for whom the Sequential Organ Failure Assessment (SOFA) score and the Infection Probability Score (IPS) were calculated on admission and every 48 hours until discharge or death. Sensitivity and specificity of the two scoring systems were measured by the chi-square method. The Youden index and area under the Receiver Operating Characteristic (ROC) curve were also obtained.
For prediction of MVN, the best cut-off points were 2.5, 3.5, 2.5 for SOFA and 10.5, 10.5, 9.5 for IPS on the day of admission (0) and days 2 and 4, respectively. For the prediction of MVN, SOFA on days 0, 2 and 4 yielded significantly better results in the area under the ROC curve and Youden index than those of IPS (p<0.05). Neither of the two scoring systems provided good discrimination in prediction of more than 3 days respiratory support under MV.
For prediction of MVN, the SOFA scoring system on days 0, 2 and 4 has better accuracy than IPS.
本研究探讨两种不同评分系统预测外科重症监护病房（ICU）患者机械通气需求（MVN）及通气持续时间（DMV）的效能。
这项前瞻性观察性研究纳入了144例连续入住ICU超过24小时的患者，入院时及之后每48小时计算序贯器官衰竭评估（SOFA）评分和感染概率评分（IPS），直至出院或死亡。采用卡方检验测量两种评分系统的敏感性和特异性。同时计算约登指数及受试者工作特征（ROC）曲线下面积。
预测MVN时，入院当天（0天）、第2天和第4天SOFA评分的最佳截断点分别为2.5、3.5、2.5，IPS评分的最佳截断点分别为10.5、10.5、9.5。预测MVN时，0天、2天和4天的SOFA评分在ROC曲线下面积和约登指数方面的结果显著优于IPS评分（p<0.05）。两种评分系统在预测MV下超过3天的呼吸支持方面均未表现出良好的辨别能力。
预测MVN时，0天、2天和4天的SOFA评分系统比IPS评分系统具有更高的准确性。
