创伤患者的急性生理与慢性健康状况评分系统II（APACHE II）评分

APACHE II scoring in the injured patient.

作者信息

Rhee K J, Baxt W G, Mackenzie J R, Willits N H, Burney R E, O'Malley R J, Reid N, Schwabe D, Storer D L, Weber R

机构信息

Division of Emergency Medicine, University of California Davis Medical Center, Sacramento 95817.

出版信息

Crit Care Med. 1990 Aug;18(8):827-30. doi: 10.1097/00003246-199008000-00006.

DOI:10.1097/00003246-199008000-00006

PMID:2379396

Abstract

The purpose of this study was to measure the predictive power of Acute Physiology and Chronic Health Evaluation (APACHE II) with respect to mortality in a group of seriously injured patients and to compare this predictive power with that of the Trauma Score (TS) and the Injury Severity Score (ISS). Six hundred ninety-one helicopter-transported patients were studied. Individual logistic regressions demonstrated that all three scores had significant predictive power when considered individually (TS chi 2 = 136, p less than .0001; APACHE II chi 2 = 171, p less than .0001; ISS chi 2 = 109, p less than .0001). In addition, each severity score added significantly to the predictive power in a stepwise logistic regression (TS chi 2 = 15, p less than .0001; APACHE II chi 2 = 45, p less than .0001; ISS chi 2 = 15, p less than .0001). Areas under the receiver operating curves for the three scores were not significantly different (TS 0.8116, SD 0.0245; APACHE II 0.8515, SD 0.0204; ISS 0.7967; SD 0.0223). APACHE II is a good predictor of mortality, and its predictive power is complemented by TS and ISS.

摘要

本研究的目的是测量急性生理学与慢性健康状况评估系统（APACHE II）对一组重伤患者死亡率的预测能力，并将该预测能力与创伤评分（TS）和损伤严重程度评分（ISS）进行比较。对691例通过直升机转运的患者进行了研究。单因素逻辑回归分析表明，单独考虑时，所有这三个评分都具有显著的预测能力（TS卡方=136，p<0.0001；APACHE II卡方=171，p<0.0001；ISS卡方=109，p<0.0001）。此外，在逐步逻辑回归中，每个严重程度评分都显著增加了预测能力（TS卡方=15，p<0.0001；APACHE II卡方=45，p<0.0001；ISS卡方=15，p<0.0001）。这三个评分的受试者工作特征曲线下面积无显著差异（TS为0.8116，标准差为0.0245；APACHE II为0.8515，标准差为0.0204；ISS为0.7967，标准差为0.0223）。APACHE II是死亡率的良好预测指标，其预测能力得到了TS和ISS的补充。