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急性生理与慢性健康状况评分系统-II(APACHE-II)评分与重症监护病房死亡率及住院时间的相关性

APACHE-II score correlation with mortality and length of stay in an intensive care unit.

作者信息

Naved Saad Ahmed, Siddiqui Shahla, Khan Fazal Hameed

机构信息

Department of Anaesthesia, The Aga Khan University Hospital, Karachi.

出版信息

J Coll Physicians Surg Pak. 2011 Jan;21(1):4-8.

Abstract

OBJECTIVE

To correlate the APACHE-II score system with mortality and length of stay in ICU.

STUDY DESIGN

Cohort study.

PLACE AND DURATION OF STUDY

The Intensive Care Unit (ICU) of the Aga Khan University Hospital, Karachi, from May 2005 to May 2006.

METHODOLOGY

All adult patients who were admitted in the ICU were included. APACHE-II score was calculated at the second and seventh days of admission in the ICU. Patients who were discharged alive from the ICU or died after first APACHE-II Score (at 2nd day) were noted as the primary outcome measurement. Second APACHE-II score (at 7th day) was used to predict the length of stay in the ICU. Pearson's correlation coefficient (r) was determined with significance at p < 0.05.

RESULTS

In the lowest score category 3-10, 27 out of 30 patients (90%) were discharged and only 3 (10%) died. Out of those 39 patients whose APACHE-II score was found in high category 31-40, 33 (84.6%) deaths were observed. This revealed that there might be more chances of death in case of high APACHE-II score (p=0.001). Insignificant but an inverse correlation (r = -0.084, p < 0.183) was observed between APACHE-II score and length of ICU stay.

CONCLUSION

The APACHE-II scoring system was found useful for classifying patients according to their disease severity. There was an inverse relationship between the high score and the length of stay as well higher chances of mortality.

摘要

目的

将急性生理学及慢性健康状况评分系统II(APACHE-II)与重症监护病房(ICU)的死亡率和住院时间相关联。

研究设计

队列研究。

研究地点及时间

2005年5月至2006年5月,卡拉奇阿迦汗大学医院重症监护病房。

方法

纳入所有入住ICU的成年患者。在入住ICU的第二天和第七天计算APACHE-II评分。将从ICU存活出院或在首次APACHE-II评分(第二天)后死亡的患者作为主要结局指标。使用第二次APACHE-II评分(第七天)预测在ICU的住院时间。确定Pearson相关系数(r),p<0.05时有统计学意义。

结果

在最低评分类别3 - 10中,30名患者中有27名(90%)出院,仅3名(10%)死亡。在APACHE-II评分处于高类别31 - 40的39名患者中,观察到33例(84.6%)死亡。这表明APACHE-II评分高时死亡几率可能更高(p = 0.001)。观察到APACHE-II评分与ICU住院时间之间存在不显著但呈负相关(r = -0.084,p < 0.183)。

结论

发现APACHE-II评分系统有助于根据疾病严重程度对患者进行分类。高分与住院时间以及更高的死亡几率之间存在负相关关系。

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