Qiao Q, Lu G, Li M, Shen Y, Xu D
Department of Nephrology, First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu Province 215006, China.
J Int Med Res. 2012;40(3):1114-21. doi: 10.1177/147323001204000331.
Performances of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score were assessed in predicting mortality outcome in critically ill elderly patients.
Mean APACHE II and SOFA scores were compared in 106 intensive care unit patients aged > 65 years classified as survivors or deaths. The discriminatory ability of the scores was evaluated using the area under the receiver operating characteristic (ROC) curve. Calibration was assessed using the Hosmer-Lemeshow test.
Mean APACHE II and SOFA scores in survivors were lower than in those who died. There was a positive correlation between the APACHE II and SOFA scores. The area under the ROC curve was 0.76 for the APACHE II score and ranged from 0.74 for the initial SOFA score to 0.98 for the maximum SOFA score. Hosmer-Lemeshow values for the APACHE II score and various SOFA scores indicated that predictions based on these scores closely fit the observed outcomes.
APACHE II and SOFA scores can accurately predict mortality outcome in critically ill elderly patients, especially the maximum SOFA score and the difference between the maximum and initial SOFA scores.
评估急性生理学与慢性健康状况评分系统II（APACHE II）和序贯器官衰竭评估（SOFA）评分在预测老年危重症患者死亡结局方面的表现。
比较了106例年龄>65岁的重症监护病房患者（分为存活者和死亡者）的平均APACHE II评分和SOFA评分。使用受试者工作特征（ROC）曲线下面积评估评分的鉴别能力。使用Hosmer-Lemeshow检验评估校准情况。
存活者的平均APACHE II评分和SOFA评分低于死亡者。APACHE II评分与SOFA评分之间存在正相关。APACHE II评分的ROC曲线下面积为0.76，初始SOFA评分的ROC曲线下面积为0.74，最高SOFA评分为0.98。APACHE II评分和各种SOFA评分的Hosmer-Lemeshow值表明，基于这些评分的预测与观察到的结局密切相符。
APACHE II评分和SOFA评分可以准确预测老年危重症患者的死亡结局，尤其是最高SOFA评分以及最高与初始SOFA评分之间的差值。
