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肺损伤预测评分有助于预测外科重症监护患者的急性呼吸窘迫综合征及死亡率。

Lung Injury Prediction Score Is Useful in Predicting Acute Respiratory Distress Syndrome and Mortality in Surgical Critical Care Patients.

作者信息

Bauman Zachary M, Gassner Marika Y, Coughlin Megan A, Mahan Meredith, Watras Jill

机构信息

Henry Ford Hospital, Detroit, MI 48202, USA.

出版信息

Crit Care Res Pract. 2015;2015:157408. doi: 10.1155/2015/157408. Epub 2015 Aug 2.

Abstract

Background. Lung injury prediction score (LIPS) is valuable for early recognition of ventilated patients at high risk for developing acute respiratory distress syndrome (ARDS). This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients. Methods. IRB approved, prospective observational study including all ventilated patients admitted to the surgical intensive care unit at a single tertiary center over 6 months. ARDS was defined using the Berlin criteria. LIPS were calculated for all patients and analyzed. Logistic regression models evaluated the ability of LIPS to predict development of ARDS and mortality. A receiver operator characteristic (ROC) curve demonstrated the optimal LIPS value to statistically predict development of ARDS. Results. 268 ventilated patients were observed; 141 developed ARDS and 127 did not. The average LIPS for patients who developed ARDS was 8.8 ± 2.8 versus 5.4 ± 2.8 for those who did not (p < 0.001). An ROC area under the curve of 0.79 demonstrates LIPS is statistically powerful for predicting ARDS development. Furthermore, for every 1-unit increase in LIPS, the odds of developing ARDS increase by 1.50 (p < 0.001) and odds of ICU mortality increase by 1.22 (p < 0.001). Conclusion. LIPS is reliable for predicting development of ARDS and predicting mortality in critically ill surgical patients.

摘要

背景。肺损伤预测评分(LIPS)对于早期识别有发生急性呼吸窘迫综合征(ARDS)高风险的机械通气患者具有重要价值。本研究分析了LIPS在预测外科机械通气患者发生ARDS及死亡方面的价值。方法。经机构审查委员会(IRB)批准的前瞻性观察性研究,纳入了一家三级中心外科重症监护病房6个月内收治的所有机械通气患者。ARDS根据柏林标准进行定义。计算并分析了所有患者的LIPS。逻辑回归模型评估了LIPS预测ARDS发生及死亡的能力。受试者工作特征(ROC)曲线显示了用于统计学预测ARDS发生的最佳LIPS值。结果。观察了268例机械通气患者;141例发生ARDS,127例未发生。发生ARDS患者的平均LIPS为8.8±2.8,未发生ARDS患者的平均LIPS为5.4±2.8(p<0.001)。曲线下面积(AUC)为0.79表明LIPS在统计学上对预测ARDS发生具有强大作用。此外,LIPS每增加1个单位,发生ARDS的几率增加1.50(p<0.001),重症监护病房(ICU)死亡几率增加1.22(p<0.001)。结论。LIPS在预测重症外科患者发生ARDS及死亡方面是可靠的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b35/4537732/24bdbe66667c/CCRP2015-157408.001.jpg

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