格拉斯哥昏迷量表与无反应性全面评分预测儿科重症监护病房患者死亡率和出院率能力的比较

Comparison between the Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score to Predict the Mortality and Discharge Rate of Pediatric Intensive Care Unit Patients.

作者信息

Khajeh Ali, Fayyazi Afshin, Miri-Aliabad Ghasem, Askari Hasan, Noori Noormohammad, Khajeh Behrouz

机构信息

Children and Adolescence Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

Iran J Pediatr. 2014 Oct;24(5):603-8. Epub 2014 Sep 12.

PMID:25793069

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4359415/

Abstract

OBJECTIVE

Prediction of survival and mortality rates in costly environments such as the intensive care unit (ICU) is of great importance for the assessment of new treatments, resource consumption control, and improvement of quality control. This study aimed to determine the ability to predict mortality and discharge rate of patients using the FOUR score in the pediatric ICU (PICU) of Ali Ibn Abitalib Hospital, Zahedan and compare the results with those of Glasgow Coma Scale (GCS).

METHODS

This prospective study was conducted on 200 patients admitted to the PICU. Convenience purposive sampling was used. Research data was collected using the Full Outline of Unresponsiveness (FOUR) score and GCS using questionnaires. Obtained data was analyzed with SPSS 16 using descriptive statistics and correlation analyses.

FINDINGS

Of the 200 children admitted to the PICU, 71.5% and 28.5% were discharged and died, respectively. The inter-rater reliability for the FOUR score was good to excellent (weighted κ: eye, 0.72; respiration, 0.82; brainstem, 0.74; motor, 0.78), In terms of mortality and discharge prediction, logistic regression analyses (FOUR score = OR: 0.13; 95% CI: 0.06-0.29; P<0.001; GCS=OR: 2.49; 95% CI: 1.44-4.32; P<0.001) showed that the FOUR score is a good predictor for in-hospital mortality.

CONCLUSION

Results indicated that the FOUR score is more capable than GCS in predicting the mortality and discharge of patients admitted to the PICU.

摘要

目的

在重症监护病房（ICU）等成本高昂的环境中预测生存率和死亡率，对于评估新治疗方法、控制资源消耗以及改善质量控制至关重要。本研究旨在确定在扎黑丹阿里·伊本·阿比塔利卜医院儿科重症监护病房（PICU）中使用FOUR评分预测患者死亡率和出院率的能力，并将结果与格拉斯哥昏迷量表（GCS）的结果进行比较。

方法

本前瞻性研究对200名入住PICU的患者进行。采用便利目的抽样法。通过问卷使用无反应性全面概述（FOUR）评分和GCS收集研究数据。使用SPSS 16对获得的数据进行描述性统计和相关性分析。

结果

在入住PICU的200名儿童中，分别有71.5%和28.5%出院和死亡。FOUR评分的评分者间信度良好至优秀（加权κ：眼部，0.72；呼吸，0.82；脑干，0.74；运动，0.78）。在死亡率和出院预测方面，逻辑回归分析（FOUR评分=比值比：0.13；95%置信区间：0.06 - 0.29；P<0.001；GCS =比值比：2.49；95%置信区间：1.44 - 4.32；P<0.001）表明，FOUR评分是住院死亡率的良好预测指标。