Department of Gastroenterology, Coimbra University Hospital, Coimbra, Portugal.
Rev Esp Enferm Dig. 2010 Oct;102(10):596-601. doi: 10.4321/s1130-01082010001000006.
Several prognostic systems have been developed and validated in general Intensive Care Units (ICUs). No assessment of these scores was performed in specialized Gastroenterology Intensive Care Units (GICUs).
To assess the prognostic accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA) scores systems to predict mortality in a GICU.
Retrospective study of 300 consecutively admissions in a GICU. Demographics, indication for admission, APACHE II, SAPS II and SOFA scores and survival at GICU discharge were recorded. Discrimination was evaluated using receiver operations characteristic (ROC) curves and area under a ROC curve (AUC). Calibration was estimated using the Hosmer-Lemeshow goodness-of-fit test.
Overall GICU mortality was 5.3%. APACHE II, SAPS II and SOFA mean scores of nonsurvivors (21.9, 46.2 and 9.3, respectively) were found to be significantly higher than those of survivors (11.9, 26.7 and 2.2, respectively) (p < 0.001). Discrimination was excellent for all the prognostic systems, with AUC = 0.900, 0.903 and 0.965 for APACHE II, SAPS II and SOFA, respectively. Similarly, APACHE II, SAPS II and SOFA scores achieved good calibration, with p = 0.671, 0.928 and 0.775, respectively. Among the three scores, SOFA showed the best performance, with overall correctness of prediction of 94.0%, while it was 86.2% for APACHE II and 82.7% for SAPS II.
in GICU, APACHE II, SAPS II and SOFA scores have excellent prognostic accuracy and, among the three scores, SOFA has the greatest overall correctness of prediction.
已经开发并验证了几种预后系统，这些系统在普通重症监护病房（ICU）中得到了应用。但尚未在专门的胃肠病学重症监护病房（GICU）中对这些评分进行评估。
评估急性生理学和慢性健康评估（APACHE）II、简化急性生理学评分（SAPS）II 和序贯器官衰竭评估（SOFA）评分系统预测 GICU 死亡率的预后准确性。
回顾性研究了 300 例连续入住 GICU 的患者。记录了患者的人口统计学资料、入院指征、APACHE II、SAPS II 和 SOFA 评分以及 GICU 出院时的生存情况。使用受试者工作特征（ROC）曲线和 ROC 曲线下面积（AUC）评估鉴别能力。通过 Hosmer-Lemeshow 拟合优度检验评估校准。
GICU 总体死亡率为 5.3%。发现死亡患者的 APACHE II、SAPS II 和 SOFA 平均评分（分别为 21.9、46.2 和 9.3）显著高于存活患者（分别为 11.9、26.7 和 2.2）（p<0.001）。所有预后系统的鉴别能力均非常出色，APACHE II、SAPS II 和 SOFA 的 AUC 分别为 0.900、0.903 和 0.965。同样，APACHE II、SAPS II 和 SOFA 评分的校准效果也很好，p 值分别为 0.671、0.928 和 0.775。在这三个评分中，SOFA 的表现最佳，整体预测准确率为 94.0%，而 APACHE II 为 86.2%，SAPS II 为 82.7%。
在 GICU 中，APACHE II、SAPS II 和 SOFA 评分具有出色的预后准确性，在这三个评分中，SOFA 的整体预测准确率最高。
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