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重症监护病房中更好的预后标志物——急性生理与慢性健康状况评分系统II（APACHE II）、序贯器官衰竭评估（SOFA）还是简化急性生理学评分II（SAP II）！

Better prognostic marker in ICU - APACHE II, SOFA or SAP II!

作者信息

Naqvi Iftikhar Haider, Mahmood Khalid, Ziaullaha Syed, Kashif Syed Mohammad, Sharif Asim

机构信息

Dr. Iftikhar Haider Naqvi, MBBS, FCPS. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Prof. Khalid Mahmood, MBBS, FCPS, FRCP(E), FRCP(G). Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2016 Sep-Oct;32(5):1146-1151. doi: 10.12669/pjms.325.10080.

DOI:10.12669/pjms.325.10080
PMID:27882011
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5103123/
Abstract

OBJECTIVES

This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients.

METHODS

This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model.

RESULTS

A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001).

CONCLUSION

All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.

摘要

目的

本研究旨在确定不同评分系统在评估危重症患者预后方面的比较疗效。

方法

这是一项回顾性研究，于2012年4月至2012年8月在市民医院第三内科的医学重症监护病房（MICU）和高依赖病房（HDU）进行。纳入所有年龄在16岁以上且符合MICU入院标准的患者。计算急性生理与慢性健康状况评分系统（APACHE II）、简化急性生理学评分系统（SAP II）和序贯器官衰竭评估（SOFA）的预测死亡率。采用校准和鉴别来评估每个评分模型的有效性。

结果

共纳入96例患者，性别分布均衡。非存活者的平均APACHE II评分（27.97 + 8.53）高于存活者（15.82 + 8.79），p值具有统计学意义（<0.001）。非存活者的平均SOFA评分（9.68 + 4.88）高于存活者（5.63 + 3.63），p值具有统计学意义（<0.001）。非存活者的SAP II平均评分（53.7l + 19.05）高于存活者（30.18 + 16.24），p值具有统计学意义（<0.001）。

结论

所有三个测试的评分模型（APACHE II、SAP II和SOFA）对于总体描述我们ICU患者的情况都足够准确。APACHE II在校准和鉴别能力方面比SAP II和SOFA表现更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34fb/5103123/58cc187bb528/PJMS-32-1146-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34fb/5103123/58cc187bb528/PJMS-32-1146-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34fb/5103123/58cc187bb528/PJMS-32-1146-g001.jpg

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