肾移植术后的急性生理与慢性健康状况评分系统IV评分
APACHE IV score in postoperative kidney transplantation.
作者信息
Rodrigues-Filho Edison Moraes, Garcez Anderson
机构信息
Unidade de Terapia Intensiva de Transplantes, Hospital Dom Vicente Scherer, Irmandade da Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil.
Rede Integrada de Pesquisa Institucional em Medicina Intensiva, Irmandade da Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil.
出版信息
Rev Bras Ter Intensiva. 2018 Apr-Jun;30(2):181-186. doi: 10.5935/0103-507X.20180032.
OBJECTIVES
To evaluate the calibration and discrimination of APACHE IV in the postoperative period after kidney transplantation.
METHODS
This clinical cohort study included 986 hospitalized adult patients in the immediate postoperative period after kidney transplantation, in a single center in southern Brazil.
RESULTS
Kidney transplant patients who died in hospital had significantly higher APACHE IV values and higher predicted mortality. The APACHE IV score showed adequate calibration (H-L 11.24 p = 0.188) and a good discrimination ROC curve of 0.738 (95%CI 0.643 - 0.833, p < 0.001), although SMR overestimated mortality (SMR = 0.73; 95%CI: 0.24 - 1.42, p = 0.664).
CONCLUSIONS
The APACHE IV score showed adequate performance for predicting hospital outcomes in the postoperative period for kidney transplant recipients.
目的
评估急性生理学及慢性健康状况评分系统（APACHE）IV在肾移植术后的校准和鉴别能力。
方法
这项临床队列研究纳入了巴西南部一个中心的986例肾移植术后即刻住院的成年患者。
结果
在医院死亡的肾移植患者的APACHE IV值显著更高，预测死亡率也更高。APACHE IV评分显示校准良好（H-L 11.24，p = 0.188），鉴别能力良好，ROC曲线为0.738（95%CI 0.643 - 0.833，p < 0.001），尽管标准化死亡比（SMR）高估了死亡率（SMR = 0.73；95%CI：0.24 - 1.42，p = 0.664）。
结论
APACHE IV评分在预测肾移植受者术后医院结局方面表现良好。
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