Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
J Korean Med Sci. 2013 Dec;28(12):1822-6. doi: 10.3346/jkms.2013.28.12.1822. Epub 2013 Nov 26.
This study assessed the ability of the Sequential Organ Failure Assessment (SOFA) and Acute Physiology, Chronic Health Evaluation (APACHE) II scoring systems, as well as the Simplified Acute Physiology Score (SAPS) II method to predict group mortality in intensive care unit (ICU) patients who were poisoned with organophosphate. The medical records of 149 organophosphate poisoned patients admitted to the ICU from September 2006 to December 2012 were retrospectively examined. The SOFA, APACHE II, and SAPS II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hr of ICU admission. The probability of death was calculated for each patient based on the SOFA score, APACHE II score, and SAPS II equations. The ability to predict group mortality by the SOFA score, APACHE II score, and SAPS II method was assessed using two by two decision matrices and receiver operating characteristic (ROC) curve analysis. A total of 131 patients (mean age, 61 yr) were enrolled. The sensitivities, specificities, and accuracies were 86.2%, 82.4%, and 83.2% for the SOFA score, respectively; 65.5%, 68.6%, and 67.9% for the APACHE II scoring system, respectively; and 86.2%, 77.5%, and 79.4% for the SAPS II, respectively. The areas under the curve in the ROC curve analysis for the SOFA score, APACHE II scoring system, and SAPS II were 0.896, 0.716, and 0.852, respectively. In conclusion, the SOFA, APACHE II, and SAPS II have different capability to discriminate and estimate early in-hospital mortality of organophosphate poisoned patients. The SOFA score is more useful in predicting mortality, and easier and simpler than the APACHE II and SAPS II.
这项研究评估了序贯器官衰竭评估(SOFA)和急性生理学与慢性健康评估(APACHE)II 评分系统,以及简化急性生理学评分(SAPS)II 方法,以预测入住重症监护病房(ICU)的有机磷中毒患者的群体死亡率。回顾性分析了 2006 年 9 月至 2012 年 12 月入住 ICU 的 149 例有机磷中毒患者的病历。根据急诊科初始实验室数据和 ICU 入院后 24 小时内的数据,计算 SOFA、APACHE II 和 SAPS II。根据 SOFA 评分、APACHE II 评分和 SAPS II 方程,计算每位患者的死亡概率。使用二维决策矩阵和受试者工作特征(ROC)曲线分析评估 SOFA 评分、APACHE II 评分和 SAPS II 方法预测群体死亡率的能力。共纳入 131 例患者(平均年龄 61 岁)。SOFA 评分的灵敏度、特异度和准确度分别为 86.2%、82.4%和 83.2%;APACHE II 评分系统分别为 65.5%、68.6%和 67.9%;SAPS II 分别为 86.2%、77.5%和 79.4%。ROC 曲线分析中 SOFA 评分、APACHE II 评分系统和 SAPS II 的曲线下面积分别为 0.896、0.716 和 0.852。总之,SOFA、APACHE II 和 SAPS II 对区分和估计有机磷中毒患者早期住院死亡率具有不同的能力。SOFA 评分在预测死亡率方面更有用,并且比 APACHE II 和 SAPS II 更简单易用。